Delivery system for cytotoxic drugs by bispecific antibody pretargeting

ABSTRACT

The present invention relates to methods and compositions for pretargeting delivery of therapeutic agents. In preferred embodiments, the pretargeting method comprises: a) administering a bispecific antibody with a first binding site for a disease-associated antigen and a hapten on a targetable construct; b) administering a targetable construct comprising at least one therapeutic agent. In preferred embodiments, the bispecific antibody is made by the dock-and-lock (DNL) technique. In a more preferred embodiment, the targetable construct comprises one or more SN-38 moieties.

RELATED APPLICATIONS

This application is a divisional of U.S. patent application Ser. No.13/710,908, filed Dec. 11, 2012, which is a divisional of U.S. patentapplication Ser. No. 12/964,132, filed Dec. 9, 2010, which was acontinuation-in-part of U.S. patent application Ser. No. 12/949,536,filed Nov. 18, 2010, (which was a divisional of Ser. No. 12/396,605,filed Mar. 3, 2009, which was a divisional of U.S. Pat. No. 7,527,787);Ser. No. 12/915,515, filed Oct. 29, 2010; Ser. No. 12/871,345, filedAug. 30, 2010; Ser. No. 12/869,823, filed Aug. 27, 2010; Ser. No.12/754,740, filed Apr. 6, 2010; Ser. No. 12/752,649, filed Apr. 1, 2010;Ser. No. 12/731,781, filed Mar. 25, 2010; Ser. No. 12/644,146 (which wasa divisional of U.S. Pat. No. 7,666,400), filed Dec. 22, 2009; Ser. No.12/544,476, filed Aug. 20, 2009; Ser. No. 12/468,589 (which was adivisional of U.S. Pat. No. 7,550,143), filed May 19, 2009; Ser. No.12/418,877, filed Apr. 6, 2009; Ser. No. 12/417,917 (which was adivisional of U.S. Pat. No. 7,534,866), filed Apr. 3, 2009; and Ser. No.12/396,965 (which was a divisional of U.S. Pat. No. 7,521,056), filedMar. 3, 2009. Those applications claimed the benefit under 35 U.S.C.119(e) of provisional U.S. Patent Applications 61/378,059, filed Aug.30, 2010; 61/323,960, filed Apr. 14, 2010; 61/316,996, filed Mar. 24,2010; 61/266,305, filed Dec. 3, 2009; 61/258,729, filed Nov. 6, 2009;61/258,369, filed Nov. 5, 2009; 61/238,424, filed Aug. 31, 2009;61/238,473, filed Aug. 31, 2009; 61/168,715, filed Apr. 13, 2009;61/168,668, filed Apr. 13, 2009; 61/168,657, filed Apr. 13, 2009;61/168,290, filed Apr. 10, 2009; 61/166,809, filed Apr. 6, 2009;61/163,666, filed Mar. 26, 2009; 61/119,542, filed Dec. 3, 2008;61/104,916, filed Oct. 13, 2008; 61/090,487, filed Aug. 20, 2008;61/043,932, filed Apr. 10, 2008; 60/864,530, filed Nov. 6, 2006;60/782,332, filed Mar. 14, 2006; 60/751,196, filed Dec. 16, 2005;60/728,292, filed Oct. 19, 2005; 60/668,603, filed Apr. 6, 2005; and60/544,227, filed Feb. 13, 2004.

This application claims the benefit of U.S. Provisional PatentApplication 61/267,998, filed Dec. 9, 2009. The text of each priorityapplication is incorporated herein by reference in its entirety.

SEQUENCE LISTING

The instant application contains a Sequence Listing which has beensubmitted in ASCII format via EFS-Web and is hereby incorporated byreference in its entirety. Said ASCII copy, created on Dec. 27, 2010, isnamed IMM325US.txt and is 29,077 bytes in size.

FIELD OF THE INVENTION

The present invention relates to therapeutic conjugates with improvedability to target diseases, such as cancer, infectious disease,autoimmune disease, immune dysfunction (e.g., graft versus host disease,organ transplant rejection), cardiovascular disease, metabolic diseaseand neurologic (e.g., neurodegenerative) disease. Preferably, thedelivery system comprises a pretargeting method in which bispecificantibodies have one or more binding sites for a disease associatedantigen and one or more binding sites for a hapten on a targetableconstruct. The targetable construct may comprise therapeutic agents,such as cytotoxic drugs, and/or diagnostic agents, such asradionuclides. More preferably, the cytotoxic drug may be SN-38. Mostpreferably, the bispecific antibody is made by the dock-and-lock (DNL)technique.

BACKGROUND OF THE INVENTION

Monoclonal antibodies have been used for the targeted delivery of toxicagents to cancer and other diseased cells. However, immunoconjugates ofantibodies and toxic agents have had mixed success in the therapy ofcancer or autoimmune disease, and little application in other diseases,such as infectious disease. The toxic agent is most commonly achemotherapy drug, although particle-emitting radionuclides, orbacterial or plant toxins have also been conjugated to antibodies,especially for the therapy of cancer (Sharkey and Goldenberg, 2006, CACancer J Clin 56:226-243) and with radioimmunoconjugates for thepreclinical therapy of certain infectious diseases (Dadachova andCasadevall, 2006, Q J Nucl Med Mol Imaging 50:193-204).

Camptothecin (CPT) and its derivatives are a class of potent antitumoragents. Irinotecan (also referred to as CPT-11) and topotecan are CPTanalogs that are approved cancer therapeutics (Iyer and Ratain, 1998,Cancer Chemother Phamacol 42:S31-S43). CPTs act by inhibitingtopoisomerase I (Hsiang et al., 1985, J Biol Chem 260:14873-78).Although potent cytotoxic agents, therapeutic use of camptothecins islimited by its relative insolubility in aqueous solution and highsystemic toxicity, which limits the effective dosage that may bedelivered to targeted disease cells. A need exists in the field for moreeffective targeted delivery methods for camptothecins and othertherapeutic agents.

SUMMARY OF THE INVENTION

The present invention resolves an unfulfilled need in the art byproviding improved methods and compositions for targeted delivery oftherapeutic agents. In preferred embodiments, the methods andcompositions comprise pretargeting with novel bispecific antibodyconstructs, which contain at least one binding site for a diseaseassociated antigen, such as a tumor-associated antigen, a B-cellassociated antigen, or a pathogen-associated antigen, and at least onebinding site for a hapten on a targetable construct. The targetableconstruct serves as a carrier for therapeutic or diagnostic agents.

More preferably, the bispecific antibody constructs are prepared by thedock-and-lock (DNL) technique (see, e.g., U.S. Pat. Nos. 7,550,143;7,521,056; 7,534,866; 7,527,787 and 7,666,400, the Examples section ofeach incorporated herein by reference). The DNL technique utilizes thespecific binding interactions occurring between a dimerization anddocking domain (DDD moiety) from protein kinase A, and an anchoringdomain (AD moiety) from any of a number of known A-kinase anchoringproteins (AKAPs). The DDD moieties spontaneously form dimers which thenbind to an AD moiety. By attaching appropriate effector moieties, suchas antibodies or fragments thereof, to AD and DDD moieties, the DNLtechnique allows the specific covalent formation of any desired targeteddelivery complex. Where the effector moiety is a protein or peptide, theAD and DDD moieties may be incorporated into fusion proteins conjugatedto the effector moieties.

Antibodies or other targeting molecules of use may bind to anydisease-associated antigen known in the art. Where the disease state iscancer, for example, many antigens expressed by or otherwise associatedwith tumor cells are known in the art, including but not limited to,carbonic anhydrase IX, alpha-fetoprotein, α-actinin-4, A3, antigenspecific for A33 antibody, ART-4, B7, Ba 733, BAGE, BrE3-antigen, CA125,CAMEL, CAP-1, CASP-8/m, CCCL19, CCCL21, CD1, CD1a, CD2, CD3, CD4, CD5,CD8, CD11A, CD14, CD15, CD16, CD18, CD19, CD20, CD21, CD22, CD23, CD25,CD29, CD30, CD32b, CD33, CD37, CD38, CD40, CD40L, CD45, CD46, CD52,CD54, CD55, CD59, CD64, CD66a-e, CD67, CD70, CD74, CD79a, CD80, CD83,CD95, CD126, CD133, CD138, CD147, CD154, CDC27, CDK-4/m, CDKN2A, CXCR4,CXCR7, CXCL12, HIF-1α, colon-specific antigen-p (CSAp), CEA (CEACAM5),CEACAM6, c-met, DAM, EGFR, EGFRvIII, EGP-1, EGP-2, ELF2-M, Ep-CAM,Flt-1, Flt-3, folate receptor, G250 antigen, GAGE, gp100, GROB, HLA-DR,HM1.24, human chorionic gonadotropin (HCG) and its subunits, HER2/neu,HMGB-1, hypoxia inducible factor (HIF-1), HSP70-2M, HST-2, Ia, IGF-1R,IFN-γ, IFN-α, IFN-β, IL-2, IL-4R, IL-6R, IL-13R, IL-15R, IL-17R, IL-18R,IL-6, IL-8, IL-12, IL-15, IL-7, IL-18, IL-25, insulin-like growthfactor-1 (IGF-1), KC4-antigen, KS-1-antigen, KS 1-4, Le-Y, LDR/FUT,macrophage migration inhibitory factor (MIF), MAGE, MAGE-3, MART-1,MART-2, NY-ESO-1, TRAG-3, mCRP, MCP-1, MIP-1A, MIP-1B, MIF, MUC1, MUC2,MUC3, MUC4, MUC5, MUM-1/2, MUM-3, NCA66, NCA95, NCA90, pancreatic cancermucin, placental growth factor, p53, PLAGL2, prostatic acid phosphatase,PSA, PRAME, PSMA, PlGF, ILGF, ILGF-1R, IL-6, IL-25, RS5, RANTES, T101,SAGE, S100, survivin, survivin-2B, TAC, TAG-72, tenascin, TRAILreceptors, TNF-α, Tn antigen, Thomson-Friedenreich antigens, tumornecrosis antigens, VEGFR, ED-B fibronectin, WT-1, 17-1A-antigen,complement factors C3, C3a, C3b, C5a, C5, an angiogenesis marker, bcl-2,bcl-6, Kras, cMET, an oncogene marker and an oncogene product (see,e.g., Sensi et al., Clin Cancer Res 2006, 12:5023-32; Parmiani et al., JImmunol 2007, 178:1975-79; Novellino et al. Cancer Immunol Immunother2005, 54:187-207).

Exemplary antibodies that may be utilized include, but are not limitedto, hR1 (anti-IGF-1R, U.S. patent application Ser. No. 12/722,645, filedMar. 12, 2010), hPAM4 (anti-mucin, U.S. Pat. No. 7,282,567), hA20(anti-CD20, U.S. Pat. No. 7,251,164), hA19 (anti-CD19, U.S. Pat. No.7,109,304), hIMMU31 (anti-AFP, U.S. Pat. No. 7,300,655), hLL1(anti-CD74, U.S. Pat. No. 7,312,318), hLL2 (anti-CD22, U.S. Pat. No.7,074,403), hMu-9 (anti-CSAp, U.S. Pat. No. 7,387,773), hL243(anti-HLA-DR, U.S. Pat. No. 7,612,180), hMN-14 (anti-CEACAM5, U.S. Pat.No. 6,676,924), hMN-15 (anti-CEACAM6, U.S. Pat. No. 7,541,440), hRS7(anti-EGP-1, U.S. Pat. No. 7,238,785), hMN-3 (anti-CEACAM6, U.S. Pat.No. 7,541,440), Ab124 and Ab125 (anti-CXCR4, U.S. Pat. No. 7,138,496)the Examples section of each cited patent or application incorporatedherein by reference.

An antibody or antigen-binding fragment of use may be chimeric,humanized or human. The use of chimeric antibodies is preferred to theparent murine antibodies because they possess human antibody constantregion sequences and therefore do not elicit as strong a humananti-mouse antibody (HAMA) response as murine antibodies. The use ofhumanized antibodies is even more preferred, in order to further reducethe possibility of inducing a HAMA reaction. As discussed below,techniques for humanization of murine antibodies by replacing murineframework and constant region sequences with corresponding humanantibody framework and constant region sequences are well known in theart and have been applied to numerous murine anti-cancer antibodies.Antibody humanization may also involve the substitution of one or morehuman framework amino acid residues with the corresponding residues fromthe parent murine framework region sequences. As also discussed below,techniques for production of human antibodies are also well known.

Various embodiments may concern use of the subject methods andcompositions to treat a disease, including but not limited tonon-Hodgkin's lymphomas, B-cell acute and chronic lymphoid leukemias,Burkitt lymphoma, Hodgkin's lymphoma, hairy cell leukemia, acute andchronic myeloid leukemias, T-cell lymphomas and leukemias, multiplemyeloma, glioma, Waldenstrom's macroglobulinemia, carcinomas, melanomas,sarcomas, gliomas, and skin cancers. The carcinomas may be selected fromthe group consisting of carcinomas of the oral cavity, gastrointestinaltract, colon, stomach, pulmonary tract, lung, breast, ovary, prostate,uterus, endometrium, cervix, urinary bladder, pancreas, bone, liver,gall bladder, kidney, skin, and testes.

In addition, the subject methods and compositions may be used to treatan autoimmune disease, for example acute idiopathic thrombocytopenicpurpura, chronic idiopathic thrombocytopenic purpura, dermatomyositis,Sydenham's chorea, myasthenia gravis, systemic lupus erythematosus,lupus nephritis, rheumatic fever, polyglandular syndromes, bullouspemphigoid, diabetes mellitus, Henoch-Schonlein purpura,post-streptococcal nephritis, erythema nodosum, Takayasu's arteritis,Addison's disease, rheumatoid arthritis, multiple sclerosis,sarcoidosis, ulcerative colitis, erythema multiforme, IgA nephropathy,polyarteritis nodosa, ankylosing spondylitis, Goodpasture's syndrome,thromboangitis obliterans, Sjogren's syndrome, primary biliarycirrhosis, Hashimoto's thyroiditis, thyrotoxicosis, scleroderma, chronicactive hepatitis, polymyositis/dermatomyositis, polychondritis,pemphigus vulgaris, Wegener's granulomatosis, membranous nephropathy,amyotrophic lateral sclerosis, tabes dorsalis, giant cellarteritis/polymyalgia, pernicious anemia, rapidly progressiveglomerulonephritis, psoriasis, or fibrosing alveolitis.

In certain embodiments, disease therapy may be enhanced by combinationtherapy with one or more other therapeutic agents. Known therapeuticagents of use include toxins, immunomodulators (such as cytokines,lymphokines, chemokines, growth factors and tumor necrosis factors),hormones, hormone antagonists, enzymes, oligonucleotides (such as siRNAor RNAi), photoactive therapeutic agents, anti-angiogenic agents andpro-apoptotic agents. The therapeutic agents may be delivered byconjugation to the same or different antibodies or other targetingmolecules or may be administered in unconjugated form. Other therapeuticagents may be administered before, concurrently with or after thebispecific antibody and targetable construct.

In a preferred embodiment, the therapeutic agent is a cytotoxic agent,such as a drug or a toxin. Also preferred, the drug is selected from thegroup consisting of nitrogen mustards, ethylenimine derivatives, alkylsulfonates, nitrosoureas, gemcitabine, triazenes, folic acid analogs,anthracyclines, taxanes, COX-2 inhibitors, pyrimidine analogs, purineanalogs, antibiotics, enzyme inhibitors, epipodophyllotoxins, platinumcoordination complexes, vinca alkaloids, substituted ureas, methylhydrazine derivatives, adrenocortical suppressants, hormone antagonists,endostatin, taxols, camptothecins, SN-38, doxorubicins and theiranalogs, antimetabolites, alkylating agents, antimitotics,anti-angiogenic agents, tyrosine kinase inhibitors, mTOR inhibitors,heat shock protein (HSP90) inhibitors, proteosome inhibitors, HDACinhibitors, pro-apoptotic agents, methotrexate, CPT-11, and acombination thereof.

In another preferred embodiment, the therapeutic agent is a toxinselected from the group consisting of ricin, abrin, alpha toxin,saporin, ribonuclease (RNase), DNase I, Staphylococcal enterotoxin-A,pokeweed antiviral protein, gelonin, diphtheria toxin, Pseudomonasexotoxin, and Pseudomonas endotoxin and combinations thereof. Or animmunomodulator selected from the group consisting of a cytokine, a stemcell growth factor, a lymphotoxin, a hematopoietic factor, a colonystimulating factor (CSF), an interferon (IFN), erythropoietin,thrombopoietin and a combinations thereof.

In other preferred embodiments, the therapeutic agent is a radionuclideselected from the group consisting of ¹¹¹In, ¹⁷⁷Lu, ²¹²Bi, ²¹³Bi, ²¹¹At,⁶²Cu, ⁶⁷Cu, ⁹⁰Y, ¹²⁵I, ¹³¹I, ³²P, ³³P, ⁴⁷Sc, ¹¹¹Ag, ⁶⁷Ga, ¹⁴²Pr, ¹⁵³Sm,¹⁶¹Tb, ¹⁶⁶Dy, ¹⁶⁶Ho, ¹⁸⁶Re, ¹⁸⁸Re, ¹⁸⁹Re, ²¹²Pb, ²²³Ra, ²²⁵Ac, ⁵⁹Fe,⁷⁵Se, ⁷⁷As, ⁸⁹Sr, ⁹⁹Mo, ¹⁰⁵Rh, ¹⁰⁹Pd, ¹⁴³Pr, ¹⁴⁹Pm, ¹⁶⁹Er, ¹⁹⁴Ir, ¹⁹⁸Au,¹⁹⁹Au, and ²¹¹Pb. Also preferred are radionuclides that substantiallydecay with Auger-emitting particles. For example, Co-58, Ga-67, Br-80m,Tc-99m, Rh-103m, Pt-109, In-111, Sb-119, 1-125, Ho-161, Os-189m andIr-192. Decay energies of useful beta-particle-emitting nuclides arepreferably <1,000 keV, more preferably <100 keV, and most preferably <70keV. Also preferred are radionuclides that substantially decay withgeneration of alpha-particles. Such radionuclides include, but are notlimited to: Dy-152, At-211, Bi-212, Ra-223, Rn-219, Po-215, Bi-211,Ac-225, Fr-221, At-217, Bi-213 and Fm-255. Decay energies of usefulalpha-particle-emitting radionuclides are preferably 2,000-10,000 keV,more preferably 3,000-8,000 keV, and most preferably 4,000-7,000 keV.Additional potential radioisotopes of use include ¹¹C, ¹³N, ¹⁵O, ⁷⁵Br,¹⁹⁸Au, ²²⁴Ac, ¹²⁶I, ¹³³I, ⁷⁷Br, ¹¹³In, ⁹⁵Ru, ⁹⁷Ru, ¹⁰³Ru, ¹⁰⁵Ru, ¹⁰⁷Hg,²⁰³Hg, ^(121m)Te, ^(122m)Te, ^(125m)Te, ¹⁶⁵Tm, ¹⁶⁷Tm, ¹⁶⁸Tm, ¹⁹⁷Pt,¹⁰⁹Pd, ¹⁰⁵Rh, ¹⁴²Pr, ¹⁴³Pr, ¹⁶¹Tb, ¹⁶⁶Ho, ¹⁹⁹Au, ⁵⁷Co, ⁵⁸Co, ⁵¹Cr, ⁵⁹Fe,⁷⁵Se, ²⁰¹Tl, ²²⁵Ac, ⁷⁶Br, ¹⁶⁹Yb, and the like. In other embodiments thetherapeutic agent is a photoactive therapeutic agent selected from thegroup consisting of chromogens and dyes.

Alternatively, the therapeutic agent is an enzyme selected from thegroup consisting of malate dehydrogenase, staphylococcal nuclease,delta-V-steroid isomerase, yeast alcohol dehydrogenase,alpha-glycerophosphate dehydrogenase, triose phosphate isomerase,horseradish peroxidase, alkaline phosphatase, asparaginase, glucoseoxidase, beta-galactosidase, ribonuclease, urease, catalase,glucose-6-phosphate dehydrogenase, glucoamylase andacetylcholinesterase. Such enzymes may be used, for example, incombination with prodrugs that are administered in relatively non-toxicform and converted at the target site by the enzyme into a cytotoxicagent. In other alternatives, a drug may be converted into less toxicform by endogenous enzymes in the subject but may be reconverted into acytotoxic form by the therapeutic enzyme.

The disclosed methods and compositions may thus be applied for treatmentof diseases and conditions for which targeting moieties are of use todeliver cytotoxic agents. Such diseases or conditions may becharacterized by the presence of a target molecule or target cell thatis insufficiently affected when unconjugated, or naked, targetingmoieties are used, such as in the immunotherapy of cancer or ofinfection with pathogenic organisms. (For methods of makingimmunoconjugates of antibodies with isotopes, drugs, and toxins for usein disease therapies, see, e.g., U.S. Pat. Nos. 4,699,784; 4,824,659;5,525,338; 5,677,427; 5,697,902; 5,716,595; 6,071,490; 6,187,284;6,306,393; 6,548,275; 6,653,104; 6,962,702; 7,033,572; 7,147,856;7,259,240 and U.S. Patent Appln. Publ. Nos. 20050175582 (now abandoned);20050136001; 20040166115 (now abandoned); 20040043030 (now abandoned);20030068322 (now abandoned) and 20030026764 (now abandoned), theExamples section of each incorporated herein by reference.)

Camptothecin (CPT) and its analogs and derivatives are preferredchemotherapeutic moieties, although the invention is not so limited.Other chemotherapeutic moieties that are within the scope of theinvention are taxanes (e.g, baccatin III, taxol), calicheamicin,epothilones, anthracycline drugs (e.g., doxorubicin (DOX), epirubicin,morpholinodoxorubicin (morpholino-DOX), cyanomorpholino-doxorubicin(cyanomorpholino-DOX), and 2-pyrrolinodoxorubicin (2-PDOX); see Priebe W(ed.), ACS symposium series 574, published by American Chemical Society,Washington D.C., 1995 (332 pp) and Nagy et al., Proc. Natl. Acad. Sci.USA 93:2464-2469, 1996), benzoquinoid ansamycins exemplified bygeldanamycin (DeBoer et al., Journal of Antibiotics 23:442-447, 1970;Neckers et al., Invest. New Drugs 17:361-373, 1999), and the like.

In certain embodiments involving treatment of cancer, the drugconjugates may be used in combination with surgery, radiation therapy,chemotherapy, immunotherapy with naked antibodies, radioimmunotherapy,immunomodulators, vaccines, and the like. Similar combinations arepreferred in the treatment of other diseases amenable to targetingmoieties, such as autoimmune diseases. For example, camptothecinconjugates can be combined with TNF inhibitors, B-cell antibodies,interferons, interleukins, and other effective agents for the treatmentof autoimmune diseases, such as rheumatoid arthritis, systemic lupuserythematosis, Sjögren's syndrome, multiple sclerosis, vasculitis, aswell as type-I diabetes (juvenile diabetes). These combination therapiescan allow lower doses of each therapeutic to be given in suchcombinations, thus reducing certain severe side effects, and potentiallyreducing the courses of therapy required. In viral diseases, the drugconjugates can be combined with other therapeutic drugs,immunomodulators, naked antibodies, or vaccines (e.g., antibodiesagainst hepatitis, HIV, or papilloma viruses, or vaccines based onimmunogens of these viruses). Antibodies and antigen-based vaccinesagainst these and other viral pathogens are known in the art and, insome cases, already in commercial use.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1. Synthesis of IMP 453.

FIG. 2. Activation of SN-38 for peptide conjugation.

FIG. 3. Dendron carrier for SN-38.

FIG. 4. Synthesis of azido-SN-38 for attachment to dendron.

DETAILED DESCRIPTION OF THE INVENTION Definitions

Unless otherwise specified, “a” or “an” means one or more.

As used herein, “about” means plus or minus 10%. For example, “about100” would include any number between 90 and 110.

An antibody, as described herein, refers to a full-length (i.e.,naturally occurring or formed by normal immunoglobulin gene fragmentrecombinatorial processes) immunoglobulin molecule (e.g., an IgGantibody) or an immunologically active (i.e., specifically binding)portion of an immunoglobulin molecule, like an antibody fragment.

An antibody fragment is a portion of an antibody such as F(ab′)₂, Fab′,Fab, Fv, sFv and the like. Regardless of structure, an antibody fragmentbinds with the same antigen that is recognized by the full-lengthantibody. The term “antibody fragment” also includes isolated fragmentsconsisting of the variable regions of antibodies, such as the “Fv”fragments consisting of the variable regions of the heavy and lightchains and recombinant single chain polypeptide molecules in which lightand heavy variable regions are connected by a peptide linker (“scFvproteins”).

A chimeric antibody is a recombinant protein that contains the variabledomains including the complementarity determining regions (CDRs) of anantibody derived from one species, preferably a rodent antibody, whilethe constant domains of the antibody molecule are derived from those ofa human antibody. For veterinary applications, the constant domains ofthe chimeric antibody may be derived from that of other species, such asa cat or dog.

A humanized antibody is a recombinant protein in which the CDRs from anantibody from one species; e.g., a rodent antibody, are transferred fromthe heavy and light variable chains of the rodent antibody into humanheavy and light variable domains (e.g., framework region sequences). Theconstant domains of the antibody molecule are derived from those of ahuman antibody. In certain embodiments, a limited number of frameworkregion amino acid residues from the parent (rodent) antibody may besubstituted into the human antibody framework region sequences.

A human antibody is, e.g., an antibody obtained from transgenic micethat have been “engineered” to produce specific human antibodies inresponse to antigenic challenge. In this technique, elements of thehuman heavy and light chain loci are introduced into strains of micederived from embryonic stem cell lines that contain targeted disruptionsof the endogenous murine heavy chain and light chain loci. Thetransgenic mice can synthesize human antibodies specific for particularantigens, and the mice can be used to produce human antibody-secretinghybridomas. Methods for obtaining human antibodies from transgenic miceare described by Green et al., Nature Genet. 7:13 (1994), Lonberg etal., Nature 368:856 (1994), and Taylor et al., Int. Immun. 6:579 (1994).A fully human antibody also can be constructed by genetic or chromosomaltransfection methods, as well as phage display technology, all of whichare known in the art. See for example, McCafferty et al., Nature348:552-553 (1990) for the production of human antibodies and fragmentsthereof in vitro, from immunoglobulin variable domain gene repertoiresfrom unimmunized donors. In this technique, antibody variable domaingenes are cloned in-frame into either a major or minor coat protein geneof a filamentous bacteriophage, and displayed as functional antibodyfragments on the surface of the phage particle. Because the filamentousparticle contains a single-stranded DNA copy of the phage genome,selections based on the functional properties of the antibody alsoresult in selection of the gene encoding the antibody exhibiting thoseproperties. In this way, the phage mimics some of the properties of theB-cell. Phage display can be performed in a variety of formats, forreview, see e.g. Johnson and Chiswell, Current Opinion in StructuralBiology 3:5564-571 (1993). Human antibodies may also be generated by invitro activated B-cells. See U.S. Pat. Nos. 5,567,610 and 5,229,275, theExamples section of which is incorporated herein by reference.

A therapeutic agent is a compound, molecule or atom which isadministered separately, concurrently or sequentially with an antibodymoiety or conjugated to an antibody moiety, i.e., antibody or antibodyfragment, or a subfragment, and is useful in the treatment of a disease.Examples of therapeutic agents include antibodies, antibody fragments,drugs, toxins, nucleases, hormones, immunomodulators, pro-apoptoticagents, anti-angiogenic agents, boron compounds, photoactive agents ordyes and radioisotopes. Therapeutic agents of use are described in moredetail below.

An immunoconjugate is an antibody, antibody fragment or fusion proteinconjugated to at least one therapeutic and/or diagnostic agent.

CPT is abbreviation for camptothecin, and as used in the presentapplication CPT represents camptothecin itself or an analog orderivative of camptothecin. The structures of camptothecin and some ofits analogs, with the numbering indicated and the rings labeled withletters A-E, are shown below.

-   -   CPT: R═R₂═R₃═H    -   10-Hydroxy-CPT: R₁═OH; R₂═R₃═H

-   -   R₂=ethyl; R₃═H    -   SN-38: R₁═OH; R₂=ethyl; R₃═H    -   Topotecan: R₁═OH; R₂═H; R₃═CH₂—N(CH₃)₂

In a preferred embodiment, the chemotherapeutic moiety is selected fromthe group consisting of doxorubicin (DOX), epirubicin,morpholinodoxorubicin (morpholino-DOX), cyanomorpholino-doxorubicin(cyanomorpholino-DOX), 2-pyrrolino-doxorubicin (2-PDOX), CPT, 10-hydroxycamptothecin, SN-38, topotecan, lurtotecan, 9-aminocamptothecin,9-nitrocamptothecin, taxanes, geldanamycin, ansamycins, and epothilones.In a more preferred embodiment, the chemotherapeutic moiety is SN-38.

Targetable Constructs

In certain embodiments, the moiety labeled with one or more diagnosticand/or therapeutic agents may comprise a peptide or other targetableconstruct. Labeled peptides (or proteins) may be selected to binddirectly to a targeted cell, tissue, pathogenic organism or othertarget. In other embodiments, labeled peptides may be selected to bindindirectly, for example using a bispecific antibody with one or morebinding sites for a targetable construct peptide and one or more bindingsites for a target antigen associated with a disease or condition.Bispecific antibodies may be used, for example, in a pretargetingtechnique wherein the antibody may be administered first to a subject.Sufficient time may be allowed for the bispecific antibody to bind to atarget antigen and for unbound antibody to clear from circulation. Thena targetable construct, such as a labeled peptide, may be administeredto the subject and allowed to bind to the bispecific antibody andlocalize at the diseased cell or tissue.

Such targetable constructs can be of diverse structure and are selectednot only for the availability of an antibody or fragment that binds withhigh affinity to the targetable construct, but also for rapid in vivoclearance when used within the pre-targeting method and bispecificantibodies or multispecific antibodies. Hydrophobic agents are best ateliciting strong immune responses, whereas hydrophilic agents arepreferred for rapid in vivo clearance. Thus, a balance betweenhydrophobic and hydrophilic character is established. This may beaccomplished, in part, by using hydrophilic chelating agents to offsetthe inherent hydrophobicity of many organic moieties. Also, subunits ofthe targetable construct may be chosen which have opposite solutionproperties, for example, peptides, which contain amino acids, some ofwhich are hydrophobic and some of which are hydrophilic. Aside frompeptides, carbohydrates may also be used.

Peptides having as few as two amino acid residues, preferably two to tenresidues, may be used and may also be coupled to other moieties, such aschelating agents. The linker should be a low molecular weight conjugate,preferably having a molecular weight of less than 50,000 daltons, andadvantageously less than about 20,000 daltons, 10,000 daltons or 5,000daltons. More usually, the targetable construct peptide will have fouror more residues, such as the peptide DOTA-Phe-Lys(HSG)-Tyr-Lys(HSG)-NH₂(SEQ ID NO:81), wherein DOTA is1,4,7,10-tetraazacyclododecane1,4,7,10-tetraacetic acid and HSG is thehistamine succinyl glycyl group. Alternatively, DOTA may be replaced byNOTA (1,4,7-triaza-cyclononane-1,4,7-triacetic acid), TETA(p-bromoacetamido-benzyl-tetraethylaminetetraacetic acid), NETA([2-(4,7-biscarboxymethyl[1,4,7]triazacyclononan-1-yl-ethyl]-2-carbonylmethyl-amino]aceticacid), DTPA or other known chelating moieties.

The targetable construct may also comprise unnatural amino acids, e.g.,D-amino acids, in the backbone structure to increase the stability ofthe peptide in vivo. In alternative embodiments, other backbonestructures such as those constructed from non-natural amino acids orpeptoids may be used.

The peptides used as targetable constructs are conveniently synthesizedon an automated peptide synthesizer using a solid-phase support andstandard techniques of repetitive orthogonal deprotection and coupling.Free amino groups in the peptide, that are to be used later forconjugation of chelating moieties or other agents, are advantageouslyblocked with standard protecting groups such as a Boc group, whileN-terminal residues may be acetylated to increase serum stability. Suchprotecting groups are well known to the skilled artisan. See Greene andWuts Protective Groups in Organic Synthesis, 1999 (John Wiley and Sons,N.Y.). When the peptides are prepared for later use within thebispecific antibody system, they are advantageously cleaved from theresins to generate the corresponding C-terminal amides, in order toinhibit in vivo carboxypeptidase activity. Exemplary methods of peptidesynthesis are disclosed in the Examples below.

Where pretargeting with bispecific antibodies is used, the antibody willcontain a first binding site for an antigen produced by or associatedwith a target tissue and a second binding site for a hapten on thetargetable construct. Exemplary haptens include, but are not limited to,HSG and In-DTPA. Antibodies raised to the HSG hapten are known (e.g. 679antibody) and can be easily incorporated into the appropriate bispecificantibody (see, e.g., U.S. Pat. Nos. 6,962,702; 7,138,103 and 7,300,644,incorporated herein by reference with respect to the Examples sections).However, other haptens and antibodies that bind to them are known in theart and may be used, such as In-DTPA and the 734 antibody (e.g., U.S.Pat. No. 7,534,431, the Examples section incorporated herein byreference).

In alternative embodiments, the specificity of the click chemistryreaction may be used as a substitute for the antibody-hapten bindinginteraction used in pretargeting with bispecific antibodies. Asdiscussed below, the specific reactivity of e.g., cyclooctyne moietiesfor azide moieties or alkyne moieties for nitrone moieties may be usedin an in vivo cycloaddition reaction. An antibody or other targetingmolecule is activated by incorporation of a substituted cyclooctyne, anazide or a nitrone moiety. A targetable construct is labeled with one ormore diagnostic or therapeutic agents and a complementary reactivemoiety. I.e., where the targeting molecule comprises a cyclooctyne, thetargetable construct will comprise an azide; where the targetingmolecule comprises a nitrone, the targetable construct will comprise analkyne, etc. The activated targeting molecule is administered to asubject and allowed to localize to a targeted cell, tissue or pathogen,as disclosed for pretargeting protocols. The reactive labeled targetableconstruct is then administered. Because the cyclooctyne, nitrone orazide on the targetable construct is unreactive with endogenousbiomolecules and highly reactive with the complementary moiety on thetargeting molecule, the specificity of the binding interaction resultsin the highly specific binding of the targetable construct to thetissue-localized targeting molecule.

The skilled artisan will realize that although the majority oftargetable constructs disclosed in the Examples below are peptides,other types of molecules may be used as targetable constructs. Forexample, polymeric molecules, such as polyethylene glycol (PEG), may beeasily derivatized with functional groups to bind diagnostic ortherapeutic agents. Following attachment of an appropriate reactivegroup, such as a substituted cyclooctyne, a nitrone or an azide, thelabeled polymer may be utilized for delivery of diagnostic ortherapeutic agents. Many examples of such carrier molecules are known inthe art and may be utilized, including but not limited to polymers,nanoparticles, microspheres, liposomes and micelles.

Antibodies

Target Antigens

Targeting antibodies of use may be specific to or selective for avariety of cell surface or disease-associated antigens. Exemplary targetantigens of use for imaging or treating various diseases, conditions,syndromes or disorders, such as a malignant disease, a cardiovasculardisease, an infectious disease, an inflammatory disease, an autoimmunedisease, a metabolic (e.g., endocrine) disease, or a neurological (e.g.,neurodegenerative) disease, such as Alzheimer's, may include carbonicanhydrase IX, CCCL19, CCCL21, CSAp, CD1, CD1a, CD2, CD3, CD4, CD5, CD8,CD11A, CD14, CD15, CD16, CD18, CD19, IGF-1R, CD20, CD21, CD22, CD23,CD25, CD29, CD30, CD32b, CD33, CD37, CD38, CD40, CD40L, CD45, CD46,CD52, CD54, CD55, CD59, CD64, CD66a-e, CD67, CD70, CD74, CD79a, CD80,CD83, CD95, CD126, CD133, CD138, CD147, CD154, CXCR4, CXCR7, CXCL12,HIF-1α, AFP, PSMA, CEACAM5, CEACAM6, c-met, B7, ED-B of fibronectin,Factor H, FHL-1, Flt-3, folate receptor, GROB, HMGB-1, hypoxia induciblefactor (HIF), HM1.24, insulin-like growth factor-1 (ILGF-1), IFN-γ,IFN-α, IFN-β, IL-2, IL-4R, IL-6R, IL-13R, IL-15R, IL-17R, IL-18R, IL-6,IL-8, IL-12, IL-15, IL-17, IL-18, IL-25, IP-10, MAGE, mCRP, MCP-1,MIP-1A, MIP-1B, MIF, MUC1, MUC2, MUC3, MUC4, MUC5, NCA-95, NCA-90, Ia,HM1.24, EGP-1, EGP-2, HLA-DR, tenascin, Le(y), RANTES, T101, TAC, Tnantigen, Thomson-Friedenreich antigens, tumor necrosis antigens, TNF-α,TRAIL receptor (R1 and R2), VEGFR, EGFR, PlGF, complement factors C3,C3a, C3b, C5a, C5, PLAGL2, and an oncogene product.

In certain embodiments, such as treating tumors, antibodies of use maytarget tumor-associated antigens. These antigenic markers may besubstances produced by a tumor or may be substances which accumulate ata tumor site, on tumor cell surfaces or within tumor cells. Among suchtumor-associated markers are those disclosed by Herberman,“Immunodiagnosis of Cancer”, in Fleisher ed., “The Clinical Biochemistryof Cancer”, page 347 (American Association of Clinical Chemists, 1979)and in U.S. Pat. Nos. 4,150,149; 4,361,544; and 4,444,744, the Examplessection of each of which is incorporated herein by reference. Reports ontumor associated antigens (TAAs) include Mizukami et al., (2005, NatureMed. 11:992-97); Hatfield et al., (2005, Curr. Cancer Drug Targets5:229-48); Vallbohmer et al. (2005, J. Clin. Oncol. 23:3536-44); and Renet al. (2005, Ann. Surg. 242:55-63), each incorporated herein byreference with respect to the TAAs identified.

Tumor-associated markers have been categorized by Herberman, supra, in anumber of categories including oncofetal antigens, placental antigens,oncogenic or tumor virus associated antigens, tissue associatedantigens, organ associated antigens, ectopic hormones and normalantigens or variants thereof. Occasionally, a sub-unit of atumor-associated marker is advantageously used to raise antibodieshaving higher tumor-specificity, e.g., the beta-subunit of humanchorionic gonadotropin (HCG) or the gamma region of carcinoembryonicantigen (CEA), which stimulate the production of antibodies having agreatly reduced cross-reactivity to non-tumor substances as disclosed inU.S. Pat. Nos. 4,361,644 and 4,444,744.

Another marker of interest is transmembrane activator andCAML-interactor (TACI). See Yu et al. Nat. Immunol. 1:252-256 (2000).Briefly, TACI is a marker for B-cell malignancies (e.g., lymphoma). TACIand B-cell maturation antigen (BCMA) are bound by the tumor necrosisfactor homolog—a proliferation-inducing ligand (APRIL). APRIL stimulatesin vitro proliferation of primary B and T-cells and increases spleenweight due to accumulation of B-cells in vivo. APRIL also competes withTALL-I (also called BLyS or BAFF) for receptor binding. Soluble BCMA andTACI specifically prevent binding of APRIL and block APRIL-stimulatedproliferation of primary B-cells. BCMA-Fc also inhibits production ofantibodies against keyhole limpet hemocyanin and Pneumovax in mice,indicating that APRIL and/or TALL-I signaling via BCMA and/or TACI arerequired for generation of humoral immunity. Thus, APRIL-TALL-I andBCMA-TACI form a two ligand-two receptor pathway involved in stimulationof B and T-cell function.

Where the disease involves a lymphoma, leukemia or autoimmune disorder,targeted antigens may be selected from the group consisting of CD4, CD5,CD8, CD14, CD15, CD19, CD20, CD21, CD22, CD23, CD25, CD33, CD37, CD38,CD40, CD40L, CD46, CD52, CD54, CD67, CD74, CD79a, CD80, CD126, CD138,CD154, CXCR4, B7, MUC1, Ia, Ii, HM1.24, HLA-DR, tenascin, VEGF, PlGF,ED-B fibronectin, an oncogene, an oncogene product (e.g., c-met orPLAGL2), CD66a-d, necrosis antigens, IL-2, T101, TAG, IL-6, MIF,TRAIL-R1 (DR4) and TRAIL-R2 (DR5).

Methods for Raising Antibodies

MAbs can be isolated and purified from hybridoma cultures by a varietyof well-established techniques. Such isolation techniques includeaffinity chromatography with Protein-A or Protein-G Sepharose,size-exclusion chromatography, and ion-exchange chromatography. See, forexample, Coligan at pages 2.7.1-2.7.12 and pages 2.9.1-2.9.3. Also, seeBaines et al., “Purification of Immunoglobulin G (IgG),” in METHODS INMOLECULAR BIOLOGY, VOL. 10, pages 79-104 (The Humana Press, Inc. 1992).After the initial raising of antibodies to the immunogen, the antibodiescan be sequenced and subsequently prepared by recombinant techniques.Humanization and chimerization of murine antibodies and antibodyfragments are well known to those skilled in the art, as discussedbelow.

Chimeric Antibodies

A chimeric antibody is a recombinant protein in which the variableregions of a human antibody have been replaced by the variable regionsof, for example, a mouse antibody, including thecomplementarity-determining regions (CDRs) of the mouse antibody.Chimeric antibodies exhibit decreased immunogenicity and increasedstability when administered to a subject General techniques for cloningmurine immunoglobulin variable domains are disclosed, for example, inOrlandi et al., Proc. Nat'l Acad. Sci. USA 6: 3833 (1989). Techniquesfor constructing chimeric antibodies are well known to those of skill inthe art. As an example, Leung et al., Hybridoma 13:469 (1994), producedan LL2 chimera by combining DNA sequences encoding the V_(κ) and V_(H)domains of murine LL2, an anti-CD22 monoclonal antibody, with respectivehuman κ and IgG₁ constant region domains.

Humanized Antibodies

Techniques for producing humanized MAbs are well known in the art (see,e.g., Jones et al., Nature 321: 522 (1986), Riechmann et al., Nature332: 323 (1988), Verhoeyen et al., Science 239: 1534 (1988), Carter etal., Proc. Nat'l Acad. Sci. USA 89: 4285 (1992), Sandhu, Crit. Rev.Biotech. 12: 437 (1992), and Singer et al., J. Immun. 150: 2844 (1993)).A chimeric or murine monoclonal antibody may be humanized bytransferring the mouse CDRs from the heavy and light variable chains ofthe mouse immunoglobulin into the corresponding variable domains of ahuman antibody. The mouse framework regions (FR) in the chimericmonoclonal antibody are also replaced with human FR sequences. As simplytransferring mouse CDRs into human FRs often results in a reduction oreven loss of antibody affinity, additional modification might berequired in order to restore the original affinity of the murineantibody. This can be accomplished by the replacement of one or morehuman residues in the FR regions with their murine counterparts toobtain an antibody that possesses good binding affinity to its epitope.See, for example, Tempest et al., Biotechnology 9:266 (1991) andVerhoeyen et al., Science 239: 1534 (1988). Preferred residues forsubstitution include FR residues that are located within 1, 2, or 3Angstroms of a CDR residue side chain, that are located adjacent to aCDR sequence, or that are predicted to interact with a CDR residue.

Human Antibodies

Methods for producing fully human antibodies using either combinatorialapproaches or transgenic animals transformed with human immunoglobulinloci are known in the art (e.g., Mancini et al., 2004, New Microbiol.27:315-28; Conrad and Scheller, 2005, Comb. Chem. High ThroughputScreen. 8:117-26; Brekke and Loset, 2003, Curr. Opin. Pharmacol.3:544-50). A fully human antibody also can be constructed by genetic orchromosomal transfection methods, as well as phage display technology,all of which are known in the art. See for example, McCafferty et al.,Nature 348:552-553 (1990). Such fully human antibodies are expected toexhibit even fewer side effects than chimeric or humanized antibodiesand to function in vivo as essentially endogenous human antibodies.

In one alternative, the phage display technique may be used to generatehuman antibodies (e.g., Dantas-Barbosa et al., 2005, Genet. Mol. Res.4:126-40). Human antibodies may be generated from normal humans or fromhumans that exhibit a particular disease state, such as cancer(Dantas-Barbosa et al., 2005). The advantage to constructing humanantibodies from a diseased individual is that the circulating antibodyrepertoire may be biased towards antibodies against disease-associatedantigens.

In one non-limiting example of this methodology, Dantas-Barbosa et al.(2005) constructed a phage display library of human Fab antibodyfragments from osteosarcoma patients. Generally, total RNA was obtainedfrom circulating blood lymphocytes (Id.). Recombinant Fab were clonedfrom the μ, γ and κ chain antibody repertoires and inserted into a phagedisplay library (d.). RNAs were converted to cDNAs and used to make FabcDNA libraries using specific primers against the heavy and light chainimmunoglobulin sequences (Marks et al., 1991, J. Mol. Biol. 222:581-97).Library construction was performed according to Andris-Widhopf et al.(2000, In: Phage Display Laboratory Manual, Barbas et al. (eds), 1^(st)edition, Cold Spring Harbor Laboratory Press, Cold Spring Harbor, N.Y.pp. 9.1 to 9.22). The final Fab fragments were digested with restrictionendonucleases and inserted into the bacteriophage genome to make thephage display library. Such libraries may be screened by standard phagedisplay methods, as known in the art. Phage display can be performed ina variety of formats, for their review, see e.g. Johnson and Chiswell,Current Opinion in Structural Biology 3:5564-571 (1993).

Human antibodies may also be generated by in vitro activated B-cells.See U.S. Pat. Nos. 5,567,610 and 5,229,275, incorporated herein byreference in their entirety. The skilled artisan will realize that thesetechniques are exemplary and any known method for making and screeninghuman antibodies or antibody fragments may be utilized.

In another alternative, transgenic animals that have been geneticallyengineered to produce human antibodies may be used to generateantibodies against essentially any immunogenic target, using standardimmunization protocols. Methods for obtaining human antibodies fromtransgenic mice are disclosed by Green et al., Nature Genet. 7:13(1994), Lonberg et al., Nature 368:856 (1994), and Taylor et al., Int.Immun. 6:579 (1994). A non-limiting example of such a system is theXenoMouse® (e.g., Green et al., 1999, J. Immunol. Methods 231:11-23,incorporated herein by reference) from Abgenix (Fremont, Calif.). In theXenoMouse® and similar animals, the mouse antibody genes have beeninactivated and replaced by functional human antibody genes, while theremainder of the mouse immune system remains intact.

The XenoMouse® was transformed with germline-configured YACs (yeastartificial chromosomes) that contained portions of the human IgH andIgkappa loci, including the majority of the variable region sequences,along with accessory genes and regulatory sequences. The human variableregion repertoire may be used to generate antibody producing B-cells,which may be processed into hybridomas by known techniques. A XenoMouse®immunized with a target antigen will produce human antibodies by thenormal immune response, which may be harvested and/or produced bystandard techniques discussed above. A variety of strains of XenoMouse®are available, each of which is capable of producing a different classof antibody. Transgenically produced human antibodies have been shown tohave therapeutic potential, while retaining the pharmacokineticproperties of normal human antibodies (Green et al., 1999). The skilledartisan will realize that the claimed compositions and methods are notlimited to use of the XenoMouse® system but may utilize any transgenicanimal that has been genetically engineered to produce human antibodies.

Known Antibodies

The skilled artisan will realize that the targeting molecules of use mayincorporate any antibody or fragment known in the art that has bindingspecificity for a target antigen associated with a disease state orcondition. Such known antibodies include, but are not limited to, hR1(anti-IGF-1R, U.S. patent application Ser. No. 12/772,645, filed Mar.12, 2010) hPAM4 (anti-pancreatic cancer mucin, U.S. Pat. No. 7,282,567),hA20 (anti-CD20, U.S. Pat. No. 7,251,164), hA19 (anti-CD19, U.S. Pat.No. 7,109,304), hIMMU31 (anti-AFP, U.S. Pat. No. 7,300,655), hLL1(anti-CD74, U.S. Pat. No. 7,312,318), hLL2 (anti-CD22, U.S. Pat. No.7,074,403), hMu-9 (anti-CSAp, U.S. Pat. No. 7,387,773), hL243(anti-HLA-DR, U.S. Pat. No. 7,612,180), hMN-14 (anti-CEACAM5, U.S. Pat.No. 6,676,924), hMN-15 (anti-CEACAM6, U.S. Pat. No. 7,662,378, U.S.patent application Ser. No. 12/846,062, filed Jul. 29, 2010), hRS7(anti-EGP-1, U.S. Pat. No. 7,238,785) and hMN-3 (anti-CEACAM6, U.S. Pat.No. 7,541,440), Ab124 and Ab125 (anti-CXCR4, U.S. Pat. No. 7,138,496)the Examples section of each cited patent or application incorporatedherein by reference.

Candidate anti-HIV antibodies include the anti-envelope antibodydescribed by Johansson et al. (AIDS. 2006 Oct. 3; 20(15):1911-5), aswell as the anti-HIV antibodies described and sold by Polymun (Vienna,Austria), also described in U.S. Pat. No. 5,831,034, U.S. Pat. No.5,911,989, and Vcelar et al., AIDS 2007; 21(16):2161-2170 and Joos etal., Antimicrob. Agents Chemother. 2006; 50(5):1773-9, all incorporatedherein by reference.

In one embodiment, a pharmaceutical composition of the present inventionmay be used to treat a subject having a metabolic disease, suchamyloidosis, or a neurodegenerative disease, such as Alzheimer'sdisease. Bapineuzumab is in clinical trials for Alzheimer's diseasetherapy. Other antibodies proposed for therapy of Alzheimer's diseaseinclude Alz 50 (Ksiezak-Reding et al., 1987, J Biol Chem 263:7943-47),gantenerumab, and solanezumab. Infliximab, an anti-TNF-α antibody, hasbeen reported to reduce amyloid plaques and improve cognition. Anti-CD3antibodies have been proposed for therapy of type 1 diabetes (Cernea etal., 2010, Diabetes Metab Rev 26:602-05). In addition, a pharmaceuticalcomposition of the present invention may be used to treat a subjecthaving an immune-dysregulatory disorder such as graft-versus-hostdisease or organ transplant rejection.

In a preferred embodiment, diseases that may be treated using theclaimed compositions and methods include cardiovascular diseases, suchas fibrin clots, atherosclerosis, myocardial ischemia and infarction.Antibodies to fibrin (e.g., scFv(59D8); T2GIs; MH1) are known and inclinical trials as imaging agents for disclosing said clots andpulmonary emboli, while anti-granulocyte antibodies, such as MN-3,MN-15, anti-NCA95, and anti-CD15 antibodies, can target myocardialinfarcts and myocardial ischemia. (See, e.g., U.S. Pat. Nos. 5,487,892;5,632,968; 6,294,173; 7,541,440, the Examples section of eachincorporated herein by reference) Anti-macrophage, anti-low-densitylipoprotein (LDL) and anti-CD74 (e.g., hLL1) antibodies can be used totarget atherosclerotic plaques. Abciximab (anti-glycoprotein IIb/IIIa)has been approved for adjuvant use for prevention of restenosis inpercutaneous coronary interventions and the treatment of unstable angina(Waldmann et al., 2000, Hematol 1:394-408). Anti-CD3 antibodies havebeen reported to reduce development and progression of atherosclerosis(Steffens et al., 2006, Circulation 114:1977-84). Antibodies againstoxidized LDL induced a regression of established atherosclerosis in amouse model (Ginsberg, 2007, J Am Coll Cardiol 52:2319-21). Anti-ICAM-1antibody was shown to reduce ischemic cell damage after cerebral arteryocclusion in rats (Zhang et al., 1994, Neurology 44:1747-51).Commercially available monoclonal antibodies to leukocyte antigens arerepresented by: OKT anti-T-cell monoclonal antibodies (available fromOrtho Pharmaceutical Company) which bind to normal T-lymphocytes; themonoclonal antibodies produced by the hybridomas having the ATCCaccession numbers HB44, HB55, HB12, HB78 and HB2; G7Ell, W8E7, NKP15 andGO22 (Becton Dickinson); NEN9.4 (New England Nuclear); and FMCll (SeraLabs). A description of antibodies against fibrin and platelet antigensis contained in Knight, Semin. Nucl. Med., 20:52-67 (1990).

Where bispecific antibodies are used, the second MAb may be selectedfrom any anti-hapten antibody known in the art, including but notlimited to h679 (U.S. Pat. No. 7,429,381) and 734 (U.S. Pat. Nos.7,429,381; 7,563,439; 7,666,415; and 7,534,431), the Examples section ofeach of which is incorporated herein by reference.

Various other antibodies of use are known in the art (e.g., U.S. Pat.Nos. 5,686,072; 5,874,540; 6,107,090; 6,183,744; 6,306,393; 6,653,104;6,730,300; 6,899,864; 6,926,893; 6,962,702; 7,074,403; 7,230,084;7,238,785; 7,238,786; 7,256,004; 7,282,567; 7,300,655; 7,312,318;7,585,491; 7,612,180; 7,642,239 and U.S. Patent Application Publ. No.20060193865; each incorporated herein by reference.) Such knownantibodies are of use for detection and/or treating a variety of diseasestates or conditions (e.g., hMN-14 or TF2 (CEA-expressing carcinomas),hA20 or TF-4 (lymphoma), hPAM4 or TF-10 (pancreatic cancer), RS7 (lung,breast, ovarian, prostatic cancers), hMN-15 or hMN3 (inflammation),anti-gp120 and/or anti-gp41 (HIV), anti-platelet and anti-thrombin(blood clots), anti-myosin (cardiac necrosis), anti-CXCR4 (cancer andinflammatory disease)).

Antibodies of use may be commercially obtained from a wide variety ofknown sources. For example, a variety of antibody secreting hybridomalines are available from the American Type Culture Collection (ATCC,Manassas, Va.). A large number of antibodies against various diseasetargets, including but not limited to tumor-associated antigens, havebeen deposited at the ATCC and/or have published variable regionsequences and are available for use in the claimed methods andcompositions. See, e.g., U.S. Pat. Nos. 7,312,318; 7,282,567; 7,151,164;7,074,403; 7,060,802; 7,056,509; 7,049,060; 7,045,132; 7,041,803;7,041,802; 7,041,293; 7,038,018; 7,037,498; 7,012,133; 7,001,598;6,998,468; 6,994,976; 6,994,852; 6,989,241; 6,974,863; 6,965,018;6,964,854; 6,962,981; 6,962,813; 6,956,107; 6,951,924; 6,949,244;6,946,129; 6,943,020; 6,939,547; 6,921,645; 6,921,645; 6,921,533;6,919,433; 6,919,078; 6,916,475; 6,905,681; 6,899,879; 6,893,625;6,887,468; 6,887,466; 6,884,594; 6,881,405; 6,878,812; 6,875,580;6,872,568; 6,867,006; 6,864,062; 6,861,511; 6,861,227; 6,861,226;6,838,282; 6,835,549; 6,835,370; 6,824,780; 6,824,778; 6,812,206;6,793,924; 6,783,758; 6,770,450; 6,767,711; 6,764,688; 6,764,681;6,764,679; 6,743,898; 6,733,981; 6,730,307; 6,720,155; 6,716,966;6,709,653; 6,693,176; 6,692,908; 6,689,607; 6,689,362; 6,689,355;6,682,737; 6,682,736; 6,682,734; 6,673,344; 6,653,104; 6,652,852;6,635,482; 6,630,144; 6,610,833; 6,610,294; 6,605,441; 6,605,279;6,596,852; 6,592,868; 6,576,745; 6,572,856; 6,566,076; 6,562,618;6,545,130; 6,544,749; 6,534,058; 6,528,625; 6,528,269; 6,521,227;6,518,404; 6,511,665; 6,491,915; 6,488,930; 6,482,598; 6,482,408;6,479,247; 6,468,531; 6,468,529; 6,465,173; 6,461,823; 6,458,356;6,455,044; 6,455,040, 6,451,310; 6,444,206; 6,441,143; 6,432,404;6,432,402; 6,419,928; 6,413,726; 6,406,694; 6,403,770; 6,403,091;6,395,276; 6,395,274; 6,387,350; 6,383,759; 6,383,484; 6,376,654;6,372,215; 6,359,126; 6,355,481; 6,355,444; 6,355,245; 6,355,244;6,346,246; 6,344,198; 6,340,571; 6,340,459; 6,331,175; 6,306,393;6,254,868; 6,187,287; 6,183,744; 6,129,914; 6,120,767; 6,096,289;6,077,499; 5,922,302; 5,874,540; 5,814,440; 5,798,229; 5,789,554;5,776,456; 5,736,119; 5,716,595; 5,677,136; 5,587,459; 5,443,953,5,525,338. These are exemplary only and a wide variety of otherantibodies and their hybridomas are known in the art. The skilledartisan will realize that antibody sequences or antibody-secretinghybridomas against almost any disease-associated antigen may be obtainedby a simple search of the ATCC, NCBI and/or USPTO databases forantibodies against a selected disease-associated target of interest. Theantigen binding domains of the cloned antibodies may be amplified,excised, ligated into an expression vector, transfected into an adaptedhost cell and used for protein production, using standard techniqueswell known in the art.

Antibody Fragments

Antibody fragments which recognize specific epitopes can be generated byknown techniques. The antibody fragments are antigen binding portions ofan antibody, such as F(ab)₂. Fab′, F(ab)₂, Fab, Fv, sFv and the like.F(ab′)₂ fragments can be produced by pepsin digestion of the antibodymolecule and Fab′ fragments can be generated by reducing disulfidebridges of the F(ab′)₂ fragments. Alternatively, Fab′ expressionlibraries can be constructed (Huse et al., 1989, Science, 246:1274-1281)to allow rapid and easy identification of monoclonal Fab′ fragments withthe desired specificity. An antibody fragment can be prepared byproteolytic hydrolysis of the full length antibody or by expression inE. coli or another host of the DNA coding for the fragment. Thesemethods are described, for example, by Goldenberg, U.S. Pat. Nos.4,036,945 and 4,331,647 and references contained therein, which patentsare incorporated herein in their entireties by reference. Also, seeNisonoff et al., Arch Biochem. Biophys. 89: 230 (1960); Porter, Biochem.J. 73: 119 (1959), Edelman et al., in METHODS IN ENZYMOLOGY VOL. 1, page422 (Academic Press 1967), and Coligan at pages 2.8.1-2.8.10 and2.10.-2.10.4.

A single chain Fv molecule (scFv) comprises a V_(L) domain and a V_(H)domain. The V_(L) and V_(H) domains associate to form a target bindingsite. These two domains are further covalently linked by a peptidelinker (L). Methods for making scFv molecules and designing suitablepeptide linkers are described in U.S. Pat. No. 4,704,692, U.S. Pat. No.4,946,778, R. Raag and M. Whitlow, “Single Chain Fvs.” FASEB Vol 9:73-80(1995) and R. E. Bird and B. W. Walker, “Single Chain Antibody VariableRegions,” TIBTECH, Vol 9: 132-137 (1991), incorporated herein byreference.

An scFv library with a large repertoire can be constructed by isolatingV-genes from non-immunized human donors using PCR primers correspondingto all known V_(H), V_(kappa) and V₈₀ gene families. See, e.g., Vaughnet al., Nat. Biotechnol., 14: 309-314 (1996). Following amplification,the V_(kappa) and V_(lambda) pools are combined to form one pool. Thesefragments are ligated into a phagemid vector. The scFv linker is thenligated into the phagemid upstream of the V_(L) fragment. The V_(H) andlinker-V_(L) fragments are amplified and assembled on the J_(H) region.The resulting V_(H)-linker-V_(L) fragments are ligated into a phagemidvector. The phagemid library can be panned for binding to the selectedantigen.

Other antibody fragments, for example single domain antibody fragments,are known in the art and may be used in the claimed constructs. Singledomain antibodies (VHH) may be obtained, for example, from camels,alpacas or llamas by standard immunization techniques. (See, e.g.,Muyldermans et al., TIBS 26:230-235, 2001; Yau et al., J Immunol Methods281:161-75, 2003; Maass et al., J Immunol Methods 324:13-25, 2007). TheVHH may have potent antigen-binding capacity and can interact with novelepitopes that are inaccessible to conventional VH-VL pairs. (Muyldermanset al., 2001) Alpaca serum IgG contains about 50% camelid heavy chainonly IgG antibodies (Cabs) (Maass et al., 2007). Alpacas may beimmunized with known antigens and VHHs can be isolated that bind to andneutralize the target antigen (Maass et al., 2007). PCR primers thatamplify virtually all alpaca VHH coding sequences have been identifiedand may be used to construct alpaca VHH phage display libraries, whichcan be used for antibody fragment isolation by standard biopanningtechniques well known in the art (Maass et al., 2007). These and otherknown antigen-binding antibody fragments may be utilized in the claimedmethods and compositions.

General Techniques for Antibody Cloning and Production

Various techniques, such as production of chimeric or humanizedantibodies, may involve procedures of antibody cloning and construction.The antigen-binding V_(κ) (variable light chain) and V_(H) (variableheavy chain) sequences for an antibody of interest may be obtained by avariety of molecular cloning procedures, such as RT-PCR, 5′-RACE, andcDNA library screening. The V genes of a MAb from a cell that expressesa murine MAb can be cloned by PCR amplification and sequenced. Toconfirm their authenticity, the cloned V_(L) and V_(H) genes can beexpressed in cell culture as a chimeric Ab as described by Orlandi etal., (Proc. Natl. Acad. Sci., USA, 86: 3833 (1989)). Based on the V genesequences, a humanized MAb can then be designed and constructed asdescribed by Leung et al. (Mol. Immunol., 32: 1413 (1995)).

cDNA can be prepared from any known hybridoma line or transfected cellline producing a murine MAb by general molecular cloning techniques(Sambrook et al., Molecular Cloning, A laboratory manual, 2^(nd) Ed(1989)). The V_(κ) sequence for the MAb may be amplified using theprimers VK1BACK and VK1FOR (Orlandi et al., 1989) or the extended primerset described by Leung et al. (BioTechniques, 15: 286 (1993)). The V_(H)sequences can be amplified using the primer pair VH1BACK/VH1FOR (Orlandiet al., 1989) or the primers annealing to the constant region of murineIgG described by Leung et al. (Hybridoma, 13:469 (1994)). Humanized Vgenes can be constructed by a combination of long oligonucleotidetemplate syntheses and PCR amplification as described by Leung et al.(Mol. Immunol., 32: 1413 (1995)).

PCR products for V_(κ) can be subcloned into a staging vector, such as apBR327-based staging vector, VKpBR, that contains an Ig promoter, asignal peptide sequence and convenient restriction sites. PCR productsfor V_(H) can be subcloned into a similar staging vector, such as thepBluescript-based VHpBS. Expression cassettes containing the V_(κ) andV_(H) sequences together with the promoter and signal peptide sequencescan be excised from VKpBR and VHpBS and ligated into appropriateexpression vectors, such as pKh and pG1g, respectively (Leung et al.,Hybridoma, 13:469 (1994)). The expression vectors can be co-transfectedinto an appropriate cell and supernatant fluids monitored for productionof a chimeric, humanized or human MAb. Alternatively, the V_(κ) andV_(H) expression cassettes can be excised and subcloned into a singleexpression vector, such as pdHL2, as described by Gillies et al. (J.Immunol. Methods 125:191 (1989) and also shown in Losman et al., Cancer,80:2660 (1997)).

In an alternative embodiment, expression vectors may be transfected intohost cells that have been pre-adapted for transfection, growth andexpression in serum-free medium. Exemplary cell lines that may be usedinclude the Sp/EEE, Sp/ESF and Sp/ESF-X cell lines (see, e.g., U.S. Pat.Nos. 7,531,327; 7,537,930 and 7,608,425; the Examples section of each ofwhich is incorporated herein by reference). These exemplary cell linesare based on the Sp2/0 myeloma cell line, transfected with a mutantBcl-EEE gene, exposed to methotrexate to amplify transfected genesequences and pre-adapted to serum-free cell line for proteinexpression.

Bispecific and Multispecific Antibodies

In certain embodiments, the techniques and compositions for therapeuticagent delivery disclosed herein may be used with bispecific ormultispecific antibodies as the targeting moieties. Numerous methods toproduce bispecific or multispecific antibodies are known, as disclosed,for example, in U.S. Pat. No. 7,405,320, the Examples section of whichis incorporated herein by reference. Bispecific antibodies can beproduced by the quadroma method, which involves the fusion of twodifferent hybridomas, each producing a monoclonal antibody recognizing adifferent antigenic site (Milstein and Cuello, Nature, 1983;305:537-540).

Another method for producing bispecific antibodies usesheterobifunctional cross-linkers to chemically tether two differentmonoclonal antibodies (Staerz, et al. Nature. 1985; 314:628-631; Perez,et al. Nature. 1985; 316:354-356). Bispecific antibodies can also beproduced by reduction of each of two parental monoclonal antibodies tothe respective half molecules, which are then mixed and allowed toreoxidize to obtain the hybrid structure (Staerz and Bevan. Proc NatlAcad Sci USA. 1986; 83:1453-1457). Another alternative involveschemically cross-linking two or three separately purified Fab′ fragmentsusing appropriate linkers. (See, e.g., European Patent Application0453082).

Other methods include improving the efficiency of generating hybridhybridomas by gene transfer of distinct selectable markers viaretrovirus-derived shuttle vectors into respective parental hybridomas,which are fused subsequently (DeMonte, et al. Proc Natl Acad Sci USA.1990, 87:2941-2945); or transfection of a hybridoma cell line withexpression plasmids containing the heavy and light chain genes of adifferent antibody.

Cognate V_(H) and V_(L) domains can be joined with a peptide linker ofappropriate composition and length (usually consisting of more than 12amino acid residues) to form a single-chain Fv (scFv) with bindingactivity. Methods of manufacturing scFvs are disclosed in U.S. Pat. No.4,946,778 and U.S. Pat. No. 5,132,405, the Examples section of each ofwhich is incorporated herein by reference. Reduction of the peptidelinker length to less than 12 amino acid residues prevents pairing ofV_(H) and V_(L) domains on the same chain and forces pairing of V_(H)and V_(L) domains with complementary domains on other chains, resultingin the formation of functional multimers. Polypeptide chains of V_(H)and V_(L) domains that are joined with linkers between 3 and 12 aminoacid residues form predominantly dimers (termed diabodies). With linkersbetween 0 and 2 amino acid residues, trimers (termed triabody) andtetramers (termed tetrabody) are favored, but the exact patterns ofoligomerization appear to depend on the composition as well as theorientation of V-domains (V_(H)-linker-V_(L) or V_(L)-linker-V_(H)), inaddition to the linker length.

These techniques for producing multispecific or bispecific antibodiesexhibit various difficulties in terms of low yield, necessity forpurification, low stability or the labor-intensiveness of the technique.More recently, a technique known as “dock and lock” (DNL) has beenutilized to produce combinations of virtually any desired antibodies,antibody fragments and other effector molecules (see, e.g., U.S. Pat.Nos. 7,550,143; 7,521,056; 7,534,866; 7,527,787 and U.S. Ser. No.11/925,408, the Examples section of each of which incorporated herein byreference). The technique utilizes complementary protein bindingdomains, referred to as anchoring domains (AD) and dimerization anddocking domains (DDD), which bind to each other and allow the assemblyof complex structures, ranging from dimers, trimers, tetramers,quintamers and hexamers. These form stable complexes in high yieldwithout requirement for extensive purification. The DNL technique allowsthe assembly of monospecific, bispecific or multispecific antibodies.Any of the techniques known in the art for making bispecific ormultispecific antibodies may be utilized in the practice of thepresently claimed methods.

In various embodiments, a conjugate as disclosed herein may be part of acomposite, multispecific antibody. Such antibodies may contain two ormore different antigen binding sites, with differing specificities. Themultispecific composite may bind to different epitopes of the sameantigen, or alternatively may bind to two different antigens.

Dock-and-Lock (DNL)

In preferred embodiments, bispecific or multispecific antibodies orother constructs may be produced using the dock-and-lock technology(see, e.g., U.S. Pat. Nos. 7,550,143; 7,521,056; 7,534,866; 7,527,787and 7,666,400, the Examples section of each incorporated herein byreference). The DNL method exploits specific protein/proteininteractions that occur between the regulatory (R) subunits ofcAMP-dependent protein kinase (PKA) and the anchoring domain (AD) ofA-kinase anchoring proteins (AKAPs) (Baillie et al., FEBS Letters. 2005;579: 3264. Wong and Scott, Nat. Rev. Mol. Cell Biol. 2004; 5: 959). PKA,which plays a central role in one of the best studied signaltransduction pathways triggered by the binding of the second messengercAMP to the R subunits, was first isolated from rabbit skeletal musclein 1968 (Walsh et al., J. Biol. Chem. 1968; 243:3763). The structure ofthe holoenzyme consists of two catalytic subunits held in an inactiveform by the R subunits (Taylor, J. Biol. Chem. 1989; 264:8443). Isozymesof PKA are found with two types of R subunits (RI and RII), and eachtype has a and β isoforms (Scott, Pharmacol. Ther. 1991; 50:123). The Rsubunits have been isolated only as stable dimers and the dimerizationdomain has been shown to consist of the first 44 amino-terminal residues(Newlon et al., Nat. Struct. Biol. 1999; 6:222). Binding of cAMP to theR subunits leads to the release of active catalytic subunits for a broadspectrum of serine/threonine kinase activities, which are orientedtoward selected substrates through the compartmentalization of PKA viaits docking with AKAPs (Scott et al., J. Biol. Chem. 1990; 265; 21561)

Since the first AKAP, microtubule-associated protein-2, wascharacterized in 1984 (Lohmann et al., Proc. Natl. Acad. Sci USA. 1984;81:6723), more than 50 AKAPs that localize to various sub-cellularsites, including plasma membrane, actin cytoskeleton, nucleus,mitochondria, and endoplasmic reticulum, have been identified withdiverse structures in species ranging from yeast to humans (Wong andScott, Nat. Rev. Mol. Cell Biol. 2004; 5:959). The AD of AKAPs for PKAis an amphipathic helix of 14-18 residues (Carr et al., J. Biol. Chem.1991; 266:14188). The amino acid sequences of the AD are quite variedamong individual AKAPs, with the binding affinities reported for RHdimers ranging from 2 to 90 nM (Alto et al., Proc. Natl. Acad. Sci. USA.2003; 100:4445). AKAPs will only bind to dimeric R subunits. For humanRIIα, the AD binds to a hydrophobic surface formed by the 23amino-terminal residues (Colledge and Scott, Trends Cell Biol. 1999;6:216). Thus, the dimerization domain and AKAP binding domain of humanRIIα are both located within the same N-terminal 44 amino acid sequence(Newlon et al., Nat. Struct. Biol. 1999; 6:222; Newlon et al., EMBO J.2001; 20:1651), which is termed the DDD herein.

We have developed a platform technology to utilize the DDD of human RIIαand the AD of AKAP as an excellent pair of linker modules for dockingany two entities, referred to hereafter as A and B, into a noncovalentcomplex, which could be further locked into a stably tethered structurethrough the introduction of cysteine residues into both the DDD and ADat strategic positions to facilitate the formation of disulfide bonds.The general methodology of the “dock-and-lock” approach is as follows.Entity A is constructed by linking a DDD sequence to a precursor of A,resulting in a first component hereafter referred to as a. Because theDDD sequence would effect the spontaneous formation of a dimer, A wouldthus be composed of a₂. Entity B is constructed by linking an ADsequence to a precursor of B, resulting in a second component hereafterreferred to as b. The dimeric motif of DDD contained in a₂ will create adocking site for binding to the AD sequence contained in b, thusfacilitating a ready association of a₂ and b to form a binary, trimericcomplex composed of a₂b. This binding event is made irreversible with asubsequent reaction to covalently secure the two entities via disulfidebridges, which occurs very efficiently based on the principle ofeffective local concentration because the initial binding interactionsshould bring the reactive thiol groups placed onto both the DDD and ADinto proximity (Chimura et al., Proc. Natl. Acad. Sci. USA. 2001;98:8480) to ligate site-specifically. Using various combinations oflinkers, adaptor modules and precursors, a wide variety of DNLconstructs of different stoichiometry may be produced and used,including but not limited to dimeric, trimeric, tetrameric, pentamericand hexameric DNL constructs (see, e.g., U.S. Pat. Nos. 7,550,143;7,521,056; 7,534,866; 7,527,787 and 7,666,400.)

By attaching the DDD and AD away from the functional groups of the twoprecursors, such site-specific ligations are also expected to preservethe original activities of the two precursors. This approach is modularin nature and potentially can be applied to link, site-specifically andcovalently, a wide range of substances, including peptides, proteins,antibodies, antibody fragments, and other effector moieties with a widerange of activities. Utilizing the fusion protein method of constructingAD and DDD conjugated effectors described in the Examples below,virtually any protein or peptide may be incorporated into a DNLconstruct. However, the technique is not limiting and other methods ofconjugation may be utilized.

A variety of methods are known for making fusion proteins, includingnucleic acid synthesis, hybridization and/or amplification to produce asynthetic double-stranded nucleic acid encoding a fusion protein ofinterest. Such double-stranded nucleic acids may be inserted intoexpression vectors for fusion protein production by standard molecularbiology techniques (see, e.g. Sambrook et al., Molecular Cloning, Alaboratory manual, 2^(nd) Ed, 1989). In such preferred embodiments, theAD and/or DDD moiety may be attached to either the N-terminal orC-terminal end of an effector protein or peptide. However, the skilledartisan will realize that the site of attachment of an AD or DDD moietyto an effector moiety may vary, depending on the chemical nature of theeffector moiety and the part(s) of the effector moiety involved in itsphysiological activity. Site-specific attachment of a variety ofeffector moieties may be performed using techniques known in the art,such as the use of bivalent cross-linking reagents and/or other chemicalconjugation techniques.

In other alternative embodiments, click chemistry reactions may be usedto produce an AD or DDD peptide conjugated to an effector moiety, oreven to covalently attach the AD and DDD moiety to each other to providean irreversible covalent bond to stabilize the DNL complex.

Pre-Targeting

Bispecific or multispecific antibodies may be utilized in pre-targetingtechniques. Pre-targeting is a multistep process originally developed toresolve the slow blood clearance of directly targeting antibodies, whichcontributes to undesirable toxicity to normal tissues such as bonemarrow. With pre-targeting, a radionuclide or other therapeutic agent isattached to a small delivery molecule (targetable construct) that iscleared within minutes from the blood. A pre-targeting bispecific ormultispecific antibody, which has binding sites for the targetableconstruct as well as a target antigen, is administered first, freeantibody is allowed to clear from circulation and then the targetableconstruct is administered.

Pre-targeting methods are disclosed, for example, in Goodwin et al.,U.S. Pat. No. 4,863,713; Goodwin et al., J. Nucl. Med. 29:226, 1988;Hnatowich et al., J. Nucl. Med. 28:1294, 1987; Oehr et al., J. Nucl.Med. 29:728, 1988; Klibanov et al., J. Nucl. Med. 29:1951, 1988;Sinitsyn et al., J. Nucl. Med. 30:66, 1989; Kalofonos et al., J. Nucl.Med. 31:1791, 1990; Schechter et al., Int. J. Cancer 48:167, 1991;Paganelli et al., Cancer Res. 51:5960, 1991; Paganelli et al., Nucl.Med. Commun. 12:211, 1991; U.S. Pat. No. 5,256,395; Stickney et al.,Cancer Res. 51:6650, 1991; Yuan et al., Cancer Res. 51:3119, 1991; U.S.Pat. Nos. 6,077,499; 7,011,812; 7,300,644; 7,074,405; 6,962,702;7,387,772; 7,052,872; 7,138,103; 6,090,381; 6,472,511; 6,962,702; and6,962,702, each incorporated herein by reference.

A pre-targeting method of treating or diagnosing a disease or disorderin a subject may be provided by: (1) administering to the subject abispecific antibody or antibody fragment; (2) optionally administeringto the subject a clearing composition, and allowing the composition toclear the antibody from circulation; and (3) administering to thesubject the targetable construct, containing one or more chelated orchemically bound therapeutic or diagnostic agents.

Immunoconjugates

In preferred embodiments, a therapeutic or diagnostic agent may becovalently attached to an antibody or antibody fragment to form animmunoconjugate. Carrier moieties may be attached, for example toreduced SH groups and/or to carbohydrate side chains. A carrier moietycan be attached at the hinge region of a reduced antibody component viadisulfide bond formation. Alternatively, such agents can be attachedusing a heterobifunctional cross-linker, such as N-succinyl3-(2-pyridyldithio)propionate (SPDP). Yu et al., Int. J. Cancer 56: 244(1994). General techniques for such conjugation are well-known in theart. See, for example, Wong, CHEMISTRY OF PROTEIN CONJUGATION ANDCROSS-LINKING (CRC Press 1991); Upeslacis et al., “Modification ofAntibodies by Chemical Methods,” in MONOCLONAL ANTIBODIES: PRINCIPLESAND APPLICATIONS, Birch et al. (eds.), pages 187-230 (Wiley-Liss, Inc.1995); Price, “Production and Characterization of SyntheticPeptide-Derived Antibodies,” in MONOCLONAL ANTIBODIES: PRODUCTION,ENGINEERING AND CLINICAL APPLICATION, Ritter et al. (eds.), pages 60-84(Cambridge University Press 1995). Alternatively, the carrier moiety canbe conjugated via a carbohydrate moiety in the Fc region of theantibody.

Methods for conjugating functional groups to antibodies via an antibodycarbohydrate moiety are well-known to those of skill in the art. See,for example, Shih et al., Int. J. Cancer 41: 832 (1988); Shih et al.,Int. J. Cancer 46: 1101 (1990); and Shih et al., U.S. Pat. No.5,057,313, the Examples section of which is incorporated herein byreference. The general method involves reacting an antibody having anoxidized carbohydrate portion with a carrier polymer that has at leastone free amine function. This reaction results in an initial Schiff base(imine) linkage, which can be stabilized by reduction to a secondaryamine to form the final conjugate.

The Fc region may be absent if the antibody component of theimmunoconjugate is an antibody fragment. However, it is possible tointroduce a carbohydrate moiety into the light chain variable region ofa full length antibody or antibody fragment. See, for example, Leung etal., J. Immunol. 154: 5919 (1995); U.S. Pat. Nos. 5,443,953 and6,254,868, the Examples section of which is incorporated herein byreference. The engineered carbohydrate moiety is used to attach thetherapeutic or diagnostic agent.

An alternative method for attaching carrier moieties to a targetingmolecule involves use of click chemistry reactions. The click chemistryapproach was originally conceived as a method to rapidly generatecomplex substances by joining small subunits together in a modularfashion. (See, e.g., Kolb et al., 2004, Angew Chem Int Ed 40:3004-31;Evans, 2007, Aust J Chem 60:384-95.) Various forms of click chemistryreaction are known in the art, such as the Huisgen 1,3-dipolarcycloaddition copper catalyzed reaction (Tornoe et al., 2002, J OrganicChem 67:3057-64), which is often referred to as the “click reaction.”Other alternatives include cycloaddition reactions such as theDiels-Alder, nucleophilic substitution reactions (especially to smallstrained rings like epoxy and aziridine compounds), carbonyl chemistryformation of urea compounds and reactions involving carbon-carbon doublebonds, such as alkynes in thiol-yne reactions.

The azide alkyne Huisgen cycloaddition reaction uses a copper catalystin the presence of a reducing agent to catalyze the reaction of aterminal alkyne group attached to a first molecule. In the presence of asecond molecule comprising an azide moiety, the azide reacts with theactivated alkyne to form a 1,4-disubstituted 1,2,3-triazole. The coppercatalyzed reaction occurs at room temperature and is sufficientlyspecific that purification of the reaction product is often notrequired. (Rostovstev et al., 2002, Angew Chem Int Ed 41:2596; Tornoe etal., 2002, J Org Chem 67:3057.) The azide and alkyne functional groupsare largely inert towards biomolecules in aqueous medium, allowing thereaction to occur in complex solutions. The triazole formed ischemically stable and is not subject to enzymatic cleavage, making theclick chemistry product highly stable in biological systems. Althoughthe copper catalyst is toxic to living cells, the copper-based clickchemistry reaction may be used in vitro for immunoconjugate formation.

A copper-free click reaction has been proposed for covalent modificationof biomolecules. (See, e.g., Agard et al., 2004, J Am Chem Soc126:15046-47.) The copper-free reaction uses ring strain in place of thecopper catalyst to promote a [3+2] azide-alkyne cycloaddition reaction(Id.) For example, cyclooctyne is an 8-carbon ring structure comprisingan internal alkyne bond. The closed ring structure induces a substantialbond angle deformation of the acetylene, which is highly reactive withazide groups to form a triazole. Thus, cyclooctyne derivatives may beused for copper-free click reactions (Id.)

Another type of copper-free click reaction was reported by Ning et al.(2010, Angew Chem Int Ed 49:3065-68), involving strain-promotedalkyne-nitrone cycloaddition. To address the slow rate of the originalcyclooctyne reaction, electron-withdrawing groups are attached adjacentto the triple bond (Id.) Examples of such substituted cyclooctynesinclude difluorinated cyclooctynes, 4-dibenzocyclooctynol andazacyclooctyne (Id.) An alternative copper-free reaction involvedstrain-promoted akyne-nitrone cycloaddition to give N-alkylatedisoxazolines (Id.) The reaction was reported to have exceptionally fastreaction kinetics and was used in a one-pot three-step protocol forsite-specific modification of peptides and proteins (Id.) Nitrones wereprepared by the condensation of appropriate aldehydes withN-methylhydroxylamine and the cycloaddition reaction took place in amixture of acetonitrile and water (Id.) These and other known clickchemistry reactions may be used to attach carrier moieties to antibodiesin vitro.

Agard et al. (2004, J Am Chem Soc 126:15046-47) demonstrated that arecombinant glycoprotein expressed in CHO cells in the presence ofperacetylated N-azidoacetylmannosamine resulted in the bioincorporationof the corresponding N-azidoacetyl sialic acid in the carbohydrates ofthe glycoprotein. The azido-derivatized glycoprotein reactedspecifically with a biotinylated cyclooctyne to form a biotinylatedglycoprotein, while control glycoprotein without the azido moietyremained unlabeled (Id.) Laughlin et al. (2008, Science 320:664-667)used a similar technique to metabolically label cell-surface glycans inzebrafish embryos incubated with peracetylatedN-azidoacetylgalactosamine. The azido-derivatized glycans reacted withdifluorinated cyclooctyne (DIFO) reagents to allow visualization ofglycans in vivo.

The Diels-Alder reaction has also been used for in vivo labeling ofmolecules. Rossin et al. (2010, Angew Chem Int Ed 49:3375-78) reported a52% yield in vivo between a tumor-localized anti-TAG72 (CC49) antibodycarrying a trans-cyclooctene (TCO) reactive moiety and an ¹¹¹In-labeledtetrazine DOTA derivative. The TCO-labeled CC49 antibody wasadministered to mice bearing colon cancer xenografts, followed 1 daylater by injection of ¹¹¹In-labeled tetrazine probe (Id.) The reactionof radiolabeled probe with tumor localized antibody resulted inpronounced radioactivity localization in the tumor, as demonstrated bySPECT imaging of live mice three hours after injection of radiolabeledprobe, with a tumor-to-muscle ratio of 13:1 (Id.) The results confirmedthe in vivo chemical reaction of the TCO and tetrazine-labeledmolecules.

Antibody labeling techniques using biological incorporation of labelingmoieties are further disclosed in U.S. Pat. No. 6,953,675 (the Examplessection of which is incorporated herein by reference). Such “landscaped”antibodies were prepared to have reactive ketone groups on glycosylatedsites. The method involved expressing cells transfected with anexpression vector encoding an antibody with one or more N-glycosylationsites in the CH1 or V_(κ) domain in culture medium comprising a ketonederivative of a saccharide or saccharide precursor. Ketone-derivatizedsaccharides or precursors included N-levulinoyl mannosamine andN-levulinoyl fucose. The landscaped antibodies were subsequently reactedwith agents comprising a ketone-reactive moiety, such as hydrazide,hydrazine, hydroxylamino or thiosemicarbazide groups, to form a labeledtargeting molecule. Exemplary agents attached to the landscapedantibodies included chelating agents like DTPA, large drug moleculessuch as doxorubicin-dextran, and acyl-hydrazide containing peptides. Thelandscaping technique is not limited to producing antibodies comprisingketone moieties, but may be used instead to introduce a click chemistryreactive group, such as a nitrone, an azide or a cyclooctyne, onto anantibody or other biological molecule.

Modifications of click chemistry reactions are suitable for use in vitroor in vivo. Reactive targeting molecule may be formed either by eitherchemical conjugation or by biological incorporation. The targetingmolecule, such as an antibody or antibody fragment, may be activatedwith an azido moiety, a substituted cyclooctyne or alkyne group, or anitrone moiety. Where the targeting molecule comprises an azido ornitrone group, the corresponding targetable construct will comprise asubstituted cyclooctyne or alkyne group, and vice versa. Such activatedmolecules may be made by metabolic incorporation in living cells, asdiscussed above. Alternatively, methods of chemical conjugation of suchmoieties to biomolecules are well known in the art, and any such knownmethod may be utilized.

Therapeutic and Diagnostic Agents

In certain embodiments, the targeting molecules or targetable constructsdisclosed herein may be attached to one or more therapeutic and/ordiagnostic agents. Therapeutic agent are preferably selected from thegroup consisting of a radionuclide, an immunomodulator, ananti-angiogenic agent, a cytokine, a chemokine, a growth factor, ahormone, a drug, a prodrug, an enzyme, an oligonucleotide, apro-apoptotic agent, an interference RNA, a photoactive therapeuticagent, a cytotoxic agent, which may be a chemotherapeutic agent or atoxin, and a combination thereof. The drugs of use may possess apharmaceutical property selected from the group consisting ofantimitotic, antikinase, alkylating, antimetabolite, antibiotic,alkaloid, anti-angiogenic, pro-apoptotic agents and combinationsthereof.

Exemplary drugs of use include, but are not limited to, 5-fluorouracil,aplidin, azaribine, anastrozole, anthracyclines, bendamustine,bleomycin, bortezomib, bryostatin-1, busulfan, calicheamycin,camptothecin, carboplatin, 10-hydroxycamptothecin, carmustine, celebrex,chlorambucil, cisplatin (CDDP), Cox-2 inhibitors, irinotecan (CPT-11),SN-38, carboplatin, cladribine, camptothecans, cyclophosphamide,cytarabine, dacarbazine, docetaxel, dactinomycin, daunorubicin,doxorubicin, 2-pyrrolinodoxorubicine (2P-DOX), cyano-morpholinodoxorubicin, doxorubicin glucuronide, epirubicin glucuronide,estramustine, epipodophyllotoxin, estrogen receptor binding agents,etoposide (VP16), etoposide glucuronide, etoposide phosphate,floxuridine (FUdR), 3′,5′-O-dioleoyl-FudR (FUdR-dO), fludarabine,flutamide, farnesyl-protein transferase inhibitors, gemcitabine,hydroxyurea, idarubicin, ifosfamide, L-asparaginase, lenolidamide,leucovorin, lomustine, mechlorethamine, melphalan, mercaptopurine,6-mercaptopurine, methotrexate, mitoxantrone, mithramycin, mitomycin,mitotane, navelbine, nitrosourea, plicomycin, procarbazine, paclitaxel,pentostatin, PSI-341, raloxifene, semustine, streptozocin, tamoxifen,taxol, temazolomide (an aqueous form of DTIC), transplatinum,thalidomide, thioguanine, thiotepa, teniposide, topotecan, uracilmustard, vinorelbine, vinblastine, vincristine and vinca alkaloids.

Toxins of use may include ricin, abrin, alpha toxin, saporin,ribonuclease (RNase), e.g., onconase, DNase I, Staphylococcalenterotoxin-A, pokeweed antiviral protein, gelonin, diphtheria toxin,Pseudomonas exotoxin, and Pseudomonas endotoxin.

Immunomodulators of use may be selected from a cytokine, a stem cellgrowth factor, a lymphotoxin, an hematopoietic factor, a colonystimulating factor (CSF), an interferon (IFN), erythropoietin,thrombopoietin and a combination thereof. Specifically useful arelymphotoxins such as tumor necrosis factor (TNF), hematopoietic factors,such as interleukin (IL), colony stimulating factor, such asgranulocyte-colony stimulating factor (G-CSF) or granulocytemacrophage-colony stimulating factor (GM-CSF), interferon, such asinterferons-α, -β or -γ, and stem cell growth factor, such as thatdesignated “S1 factor”. Included among the cytokines are growth hormonessuch as human growth hormone, N-methionyl human growth hormone, andbovine growth hormone; parathyroid hormone; thyroxine; insulin;proinsulin; relaxin; prorelaxin; glycoprotein hormones such as folliclestimulating hormone (FSH), thyroid stimulating hormone (TSH), andluteinizing hormone (LH); hepatic growth factor; prostaglandin,fibroblast growth factor; prolactin; placental lactogen, OB protein;tumor necrosis factor-α and -β; mullerian-inhibiting substance; mousegonadotropin-associated peptide; inhibin; activin; vascular endothelialgrowth factor; integrin; thrombopoietin (TPO); nerve growth factors suchas NGF-β; platelet-growth factor; transforming growth factors (TGFs)such as TGF-α and TGF-β; insulin-like growth factor-I and -II;erythropoietin (EPO); osteoinductive factors; interferons such asinterferon-α, -β, and -γ; colony stimulating factors (CSFs) such asmacrophage-CSF (M-CSF); interleukins (ILs) such as IL-1, IL-1α, IL-2,IL-3, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-11, IL-12; IL-13,IL-14, IL-15, IL-16, IL-17, IL-18, IL-21, IL-25, LIF, kit-ligand orFLT-3, angiostatin, thrombospondin, endostatin, tumor necrosis factorand LT.

Chemokines of use include RANTES, MCAF, MIP1-alpha, MIP1-Beta and IP-10.

Radioactive isotopes useful for treating diseased tissue include, butare not limited to—¹¹¹In, ¹⁷⁷Lu, ²¹²Bi, ²¹³Bi, ²¹¹At, ⁶²Cu, ⁶⁷Cu, ⁹⁰Y,¹²⁵I, ¹³¹I, ³²P, ³³P, ⁴⁷Sc, ¹¹¹Ag, ⁶⁷Ga, ¹⁴²Pr, ¹⁵³Sm, ¹⁶¹Tb, ¹⁶⁶Dy,¹⁶⁶Ho, ¹⁸⁶Re, ¹⁸⁸Re, ¹⁸⁹Re, ²¹²Pb, ²²³Ra, ²²⁵Ac, ⁵⁹Fe, ⁷⁵Se, ⁷⁷As, ⁸⁹Sr,⁹⁹Mo, ¹⁰⁵Rh, ¹⁰⁹Pd, ¹⁴³Pr, ¹⁴⁹Pm, ¹⁶⁹Er, ¹⁹⁴Ir, ¹⁹⁸Au, ¹⁹⁹Au, and ²¹¹Pb.The therapeutic radionuclide preferably has a decay-energy in the rangeof 20 to 6,000 keV, preferably in the ranges 60 to 200 keV for an Augeremitter, 100-2,500 keV for a beta emitter, and 4,000-6,000 keV for analpha emitter. Maximum decay energies of useful beta-particle-emittingnuclides are preferably 20-5,000 keV, more preferably 100-4,000 keV, andmost preferably 500-2,500 keV. Also preferred are radionuclides thatsubstantially decay with Auger-emitting particles. For example, Co-58,Ga-67, Br-80m, Tc-99m, Rh-103m, Pt-109, In-111, Sb-119, 1-125, Ho-161,Os-189m and Ir-192. Decay energies of useful beta-particle-emittingnuclides are preferably <1,000 keV, more preferably <100 keV, and mostpreferably <70 keV. Also preferred are radionuclides that substantiallydecay with generation of alpha-particles. Such radionuclides include,but are not limited to: Dy-152, At-211, Bi-212, Ra-223, Rn-219, Po-215,Bi-211, Ac-225, Fr-221, At-217, Bi-213 and Fm-255. Decay energies ofuseful alpha-particle-emitting radionuclides are preferably 2,000-10,000keV, more preferably 3,000-8,000 keV, and most preferably 4,000-7,000keV. Additional potential radioisotopes of use include ¹¹C, ¹³N, ¹⁵O,⁷⁵Br, ¹⁹⁸Au, ²²⁴Ac, ¹²⁶I, ¹³³I, ⁷⁷Br, ^(113m)In, ⁹⁵Ru, ⁹⁷Ru, ¹⁰³Ru,¹⁰⁵Ru, ¹⁰⁷Hg, ²⁰³Hg, ^(121m)Te, ¹²²Te, ^(125m)Te, ¹⁶⁵Tm, ¹⁶⁷Tm, ¹⁶⁸Tm,¹⁹⁷Pt, ¹⁰⁹Pd, ¹⁰⁵Rh, ¹⁴²Pr, ¹⁴³Pr, ¹⁶¹Tb, ¹⁶⁶Ho, ¹⁹⁹Au, ⁵⁷Co, ⁵⁸Co,⁵¹Cr, ⁵⁹Fe, ⁷⁵Se, ²⁰¹Tl, ²²⁵Ac, ⁷⁶Br, ¹⁶⁹Yb, and the like.

Therapeutic agents may include a photoactive agent or dye. Fluorescentcompositions, such as fluorochrome, and other chromogens, or dyes, suchas porphyrins sensitive to visible light, have been used to detect andto treat lesions by directing the suitable light to the lesion. Intherapy, this has been termed photoradiation, phototherapy, orphotodynamic therapy. See Jori et al. (eds.), PHOTODYNAMIC THERAPY OFTUMORS AND OTHER DISEASES (Libreria Progetto 1985); van den Bergh, Chem.Britain (1986), 22:430. Moreover, monoclonal antibodies have beencoupled with photoactivated dyes for achieving phototherapy. See Mew etal., J. Immunol. (1983), 130:1473; idem., Cancer Res. (1985), 45:4380;Oseroff et al., Proc. Natl. Acad. Sci. USA (1986), 83:8744; idem.,Photochem. Photobiol. (1987), 46:83; Hasan et al., Prog. Clin. Biol.Res. (1989), 288:471; Tatsuta et al., Lasers Surg. Med. (1989), 9:422;Pelegrin et al., Cancer (1991), 67:2529.

Corticosteroid hormones can increase the effectiveness of otherchemotherapy agents, and consequently, they are frequently used incombination treatments. Prednisone and dexamethasone are examples ofcorticosteroid hormones.

In certain embodiments, anti-angiogenic agents, such as angiostatin,baculostatin, canstatin, maspin, anti-placenta growth factor (PlGF)peptides and antibodies, anti-vascular growth factor antibodies (such asanti-VEGF and anti-PlGF), anti-Flk-1 antibodies, anti-Flt-1 antibodiesand peptides, anti-Kras antibodies, anti-cMET antibodies, anti-MIF(macrophage migration-inhibitory factor) antibodies, laminin peptides,fibronectin peptides, plasminogen activator inhibitors, tissuemetalloproteinase inhibitors, interferons, interleukin-12, IP-10, Gro-β,thrombospondin, 2-methoxyoestradiol, proliferin-related protein,carboxiamidotriazole, CM101, Marimastat, pentosan polysulphate,angiopoietin-2, interferon-alpha, herbimycin A, PNU145156E, 16Kprolactin fragment, Linomide, thalidomide, pentoxifylline, genistein,TNP-470, endostatin, paclitaxel, accutin, angiostatin, cidofovir,vincristine, bleomycin, AGM-1470, platelet factor 4 or minocycline maybe of use.

The therapeutic agent may comprise and oligonucleotide, such as a siRNA.The skilled artisan will realize that any siRNA or interference RNAspecies may be attached to a targetable construct for delivery to atargeted tissue. Many siRNA species against a wide variety of targetsare known in the art, and any such known siRNA may be utilized in theclaimed methods and compositions.

Known siRNA species of potential use include those specific forIKK-gamma (U.S. Pat. No. 7,022,828); VEGF, Flt-1 and Flk-1/KDR (U.S.Pat. No. 7,148,342); Bcl2 and EGFR (U.S. Pat. No. 7,541,453); CDC20(U.S. Pat. No. 7,550,572); transducin (beta)-like 3 (U.S. Pat. No.7,576,196); KRAS (U.S. Pat. No. 7,576,197); carbonic anhydrase II (U.S.Pat. No. 7,579,457); complement component 3 (U.S. Pat. No. 7,582,746);interleukin-1 receptor-associated kinase 4 (IRAK4) (U.S. Pat. No.7,592,443); survivin (U.S. Pat. No. 7,608,7070); superoxide dismutase 1(U.S. Pat. No. 7,632,938); MET proto-oncogene (U.S. Pat. No. 7,632,939);amyloid beta precursor protein (APP) (U.S. Pat. No. 7,635,771); IGF-1R(U.S. Pat. No. 7,638,621); ICAM1 (U.S. Pat. No. 7,642,349); complementfactor B (U.S. Pat. No. 7,696,344); p53 (U.S. Pat. No. 7,781,575), andapolipoprotein B (U.S. Pat. No. 7,795,421), the Examples section of eachreferenced patent incorporated herein by reference.

Additional siRNA species are available from known commercial sources,such as Sigma-Aldrich (St Louis, Mo.), Invitrogen (Carlsbad, Calif.),Santa Cruz Biotechnology (Santa Cruz, Calif.), Ambion (Austin, Tex.),Dharmacon (Thermo Scientific, Lafayette, Colo.), Promega (Madison,Wis.), Mirus Bio (Madison, Wis.) and Qiagen (Valencia, Calif.), amongmany others. Other publicly available sources of siRNA species includethe siRNAdb database at the Stockholm Bioinformatics Centre, theMIT/ICBP siRNA Database, the RNAi Consortium shRNA Library at the BroadInstitute, and the Probe database at NCBI. For example, there are 30,852siRNA species in the NCBI Probe database. The skilled artisan willrealize that for any gene of interest, either a siRNA species hasalready been designed, or one may readily be designed using publiclyavailable software tools. Any such siRNA species may be delivered usingthe subject DNL complexes.

Exemplary siRNA species known in the art are listed in Table 1. AlthoughsiRNA is delivered as a double-stranded molecule, for simplicity onlythe sense strand sequences are shown in Table 1.

TABLE 1 Exemplary siRNA Sequences Target Sequence SEQ ID NO VEGF R2AATGCGGCGGTGGTGACAGTA SEQ ID NO: 1 VEGF R2 AAGCTCAGCACACAGAAAGACSEQ ID NO: 2 CXCR4 UAAAAUCUUCCUGCCCACCdTdT SEQ ID NO: 3 CXCR4GGAAGCUGUUGGCUGAAAAdTdT SEQ ID NO: 4 PPARC1 AAGACCAGCCUCUUUGCCCAGSEQ ID NO: 5 Dynamin  GGACCAGGCAGAAAACGAG SEQ ID NO: 6 2 CateninCUAUCAGGAUGACGCGG SEQ ID NO: 7 E1A   UGACACAGGCAGGCUUGACUU SEQ ID NO: 8binding protein Plas- GGTGAAGAAGGGCGTCCAA SEQ ID NO: 9 minogen activa-tor K-ras GATCCGTTGGAGCTGTTGGCGTAGTT SEQ ID NO: 10CAAGAGACTCGCCAACAGCTCCAACT TTTGGAAA Sortilin AGGTGGTGTTAACAGCAGAGSEQ ID NO: 11 1 Apolipo- AAGGTGGAGCAAGCGGTGGAG SEQ ID NO: 12 protein  EApolipo- AAGGAGTTGAAGGCCGACAAA SEQ ID NO: 13 protein  E Bcl-XUAUGGAGCUGCAGAGGAUGdTdT SEQ ID NO: 14 Raf-1 TTTGAATATCTGTGCTGAGAACACASEQ ID NO: 15 GTTCTCAGCACAGATATTCTTTTT Heat  AATGAGAAAAGCAAAAGGTGCCCTGTSEQ ID NO: 16 shock CTC trans-  cription factor 2 IGFBP3AAUCAUCAUCAAGAAAGGGCA SEQ ID NO: 17 Thiore- AUGAGUGUCAGGAUGUUGCdTdTSEQ ID NO: 18 doxin CD44 GAACGAAUCCUGAAGACAUCU SEQ ID NO: 19 MMP14AAGCCTGGCTACAGCAATATGCCTGT SEQ ID NO: 20 CTC MAPKAPK2UGACCAUCACCGAGUUUAUdTdT SEQ ID NO: 21 FGFR1 AAGTCGGACGCAACAGAGAAASEQ ID NO: 22 ERBB2 CUACCUUUCUACGGACGUGdTdT SEQ ID NO: 23 BCL2L1CTGCCTAAGGCGGATTTGAAT SEQ ID NO: 24 ABL1 TTAUUCCUUCUUCGGGAAGUCSEQ ID NO: 25 CEACAM1 AACCTTCTGGAACCCGCCCAC SEQ ID NO: 26 CD9GAGCATCTTCGAGCAAGAA SEQ ID NO: 27 CD151 CATGTGGCACCGTTTGCCTSEQ ID NO: 28 Caspase  AACTACCAGAAAGGTATACCT SEQ ID NO: 29 8 BRCA1UCACAGUGUCCUUUAUGUAdTdT SEQ ID NO: 30 p53 GCAUGAACCGGAGGCCCAUTTSEQ ID NO: 31 CEACAM6 CCGGACAGTTCCATGTATA SEQ ID NO: 32

The skilled artisan will realize that Table 1 represents a very smallsampling of the total number of siRNA species known in the art, and thatany such known siRNA may be utilized in the claimed methods andcompositions.

Diagnostic agents are preferably selected from the group consisting of aradionuclide, a radiological contrast agent, a paramagnetic ion, ametal, a fluorescent label, a chemiluminescent label, an ultrasoundcontrast agent and a photoactive agent Such diagnostic agents are wellknown and any such known diagnostic agent may be used. Non-limitingexamples of diagnostic agents may include a radionuclide such as ¹⁸F,⁵²Fe, ¹¹⁰In, ¹¹¹In, ¹⁷⁷Lu, ⁵²Fe, ⁶²Cu, ⁶⁴Cu, ⁶⁷Cu, ⁶⁷Ga, ⁶⁸Ga, ⁸⁶Y, ⁹⁰Y,⁸⁹Zr, ^(94m)Tc, ⁹⁴Tc, ^(99m)Tc, ¹²⁰I, ¹²³I, ¹²⁴I, ¹²⁵I, ¹³¹I, ¹⁵⁴⁻¹⁵⁸Gd,³²P, ¹¹C, ¹³N, ¹⁵O, ¹⁸⁶Re, ¹⁸⁸Re, ⁵¹Mn, ^(52m)Mn, ⁵⁵Co, ⁷²As, ⁷⁵Br,⁷⁶Br, ^(82m)Rb, ⁸³Sr, or other gamma-, beta-, or positron-emitters.

Paramagnetic ions of use may include chromium (III), manganese (II),iron (II), iron (II), cobalt (II), nickel (II), copper (II), neodymium(III), samarium (III), ytterbium (III), gadolinium (III), vanadium (II),terbium (III), dysprosium (III), holmium (III) or erbium (III). Metalcontrast agents may include lanthanum (III), gold (II), lead (II) orbismuth (III).

Ultrasound contrast agents may comprise liposomes, such as gas filledliposomes. Radiopaque diagnostic agents may be selected from compounds,barium compounds, gallium compounds, and thallium compounds. A widevariety of fluorescent labels are known in the art, including but notlimited to fluorescein isothiocyanate, rhodamine, phycoerytherin,phycocyanin, allophycocyanin, o-phthaldehyde and fluorescamine.Chemiluminescent labels of use may include luminol, isoluminol, anaromatic acridinium ester, an imidazole, an acridinium salt or anoxalate ester.

Therapeutic Treatment

In another aspect, the invention relates to a method of treating asubject, comprising administering a therapeutically effective amount ofa therapeutic conjugate as described herein to a subject. Diseases thatmay be treated with the therapeutic conjugates described herein include,but are not limited to B-cell malignancies (e.g., non-Hodgkin's lymphomaand chronic lymphocytic leukemia using, for example LL2 antibody; seeU.S. Pat. No. 6,183,744), adenocarcinomas of endodermally-deriveddigestive system epithelia, cancers such as breast cancer and non-smallcell lung cancer, and other carcinomas, sarcomas, glial tumors, myeloidleukemias, etc. In particular, antibodies against an antigen, e.g., anoncofetal antigen, produced by or associated with a malignant solidtumor or hematopoietic neoplasm, e.g., a gastrointestinal, lung, breast,prostate, ovarian, testicular, brain or lymphatic tumor, a sarcoma or amelanoma, are advantageously used. Such therapeutics can be given onceor repeatedly, depending on the disease state and tolerability of theconjugate, and can also be used optimally in combination with othertherapeutic modalities, such as surgery, external radiation,radioimmunotherapy, immunotherapy, chemotherapy, antisense therapy,interference RNA therapy, gene therapy, and the like. Each combinationwill be adapted to the tumor type, stage, patient condition and priortherapy, and other factors considered by the managing physician.

As used herein, the term “subject” refers to any animal (i.e.,vertebrates and invertebrates) including, but not limited to mammals,including humans. It is not intended that the term be limited to aparticular age or sex. Thus, adult and newborn subjects, as well asfetuses, whether male or female, are encompassed by the term.

In a preferred embodiment, therapeutic conjugates comprising the Mu-9antibody can be used to treat colorectal, as well as pancreatic andovarian cancers as disclosed in U.S. Pat. Nos. 6,962,702 and 7,387,772,the Examples section of each incorporated herein by reference. Inaddition, therapeutic conjugates comprising the PAM4 antibody can beused to treat pancreatic cancer, as disclosed in U.S. Pat. Nos.7,238,786 and 7,282,567, the Examples section of each incorporatedherein by reference.

In another preferred embodiment, therapeutic conjugates comprising theRS7 antibody (binding to epithelial glycoprotein-1 [EGP-1] antigen) canbe used to treat carcinomas such as carcinomas of the lung, stomach,urinary bladder, breast, ovary, uterus, and prostate, as disclosed inU.S. Pat. No. 7,238,785, the Examples section of which is incorporatedherein by reference.

In another preferred embodiment, therapeutic conjugates comprising theanti-AFP antibody can be used to treat hepatocellular carcinoma, germcell tumors, and other AFP-producing tumors using humanized, chimericand human antibody forms, as disclosed in U.S. Pat. No. 7,300,655, theExamples section of which is incorporated herein by reference.

In another preferred embodiment, therapeutic conjugates comprisinganti-tenascin antibodies can be used to treat hematopoietic and solidtumors and conjugates comprising antibodies to tenascin can be used totreat solid tumors, preferably brain cancers like glioblastomas.

In a preferred embodiment, the antibodies that are used in the treatmentof human disease are human or humanized (CDR-grafted) versions ofantibodies; although murine and chimeric versions of antibodies can beused. Same species IgG molecules as delivery agents are mostly preferredto minimize immune responses. This is particularly important whenconsidering repeat treatments. For humans, a human or humanized IgGantibody is less likely to generate an anti-IgG immune response frompatients. Antibodies such as hLL1 and hLL2 rapidly internalize afterbinding to internalizing antigen on target cells, which means that thechemotherapeutic drug being carried is rapidly internalized into cellsas well. However, antibodies that have slower rates of internalizationcan also be used to effect selective therapy.

In another preferred embodiment, the therapeutic conjugates can be usedagainst pathogens, since antibodies against pathogens are known. Forexample, antibodies and antibody fragments which specifically bindmarkers produced by or associated with infectious lesions, includingviral, bacterial, fungal and parasitic infections, for example caused bypathogens such as bacteria, rickettsia, mycoplasma, protozoa, fungi, andviruses, and antigens and products associated with such microorganismshave been disclosed, inter alia, in Hansen et al., U.S. Pat. No.3,927,193 and Goldenberg U.S. Pat. Nos. 4,331,647, 4,348,376, 4,361,544,4,468,457, 4,444,744, 4,818,709 and 4,624,846, the Examples section ofeach incorporated herein by reference, and in Reichert and Dewitz, citedabove. In a preferred embodiment, the pathogens are selected from thegroup consisting of HIV virus, Mycobacterium tuberculosis, Streptococcusagalactiae, methicillin-resistant Staphylococcus aureus, Legionellapneumophila, Streptococcus pyogenes, Escherichia coli, Neisseriagonorrhoeae, Neisseria meningitidis, Pneumococcus, Cryptococcusneoformans, Histoplasma capsulatum, Hemophilus influenzae B, Treponemapallidum, Lyme disease spirochetes, Pseudomonas aeruginosa,Mycobacterium leprae, Brucella abortus, rabies virus, influenza virus,cytomegalovirus, herpes simplex virus I, herpes simplex virus II, humanserum parvo-like virus, respiratory syncytial virus, varicella-zostervirus, hepatitis B virus, hepatitis C virus, measles virus, adenovirus,human T-cell leukemia viruses, Epstein-Barr virus, murine leukemiavirus, mumps virus, vesicular stomatitis virus, Sindbis virus,lymphocytic choriomeningitis virus, wart virus, blue tongue virus,Sendai virus, feline leukemia virus, Reovirus, polio virus, simian virus40, mouse mammary tumor virus, dengue virus, rubella virus, West Nilevirus, Plasmodium falciparum, Plasmodium vivax, Toxoplasma gondii,Trypanosoma rangeli, Trypanosoma cruzi, Trypanosoma rhodesiense,Trypanosoma brucei, Schistosoma mansoni, Schistosoma japonicum, Babesiabovis, Eimeria tenella, Onchocerca volvulus, Leishmania tropica,Trichinella spiralis, Theileria parva, Taenia hydatigena, Taenia ovis,Taenia saginata, Echinococcus granulosus, Mesocestoides corti,Mycoplasma arthritidis, M. hyorhinis, M. orale, M. arginini,Acholeplasma laidlawii, M. salivarium and M. pneumoniae, as disclosed inU.S. Pat. No. 6,440,416, the Examples section of which is incorporatedherein by reference.

In a more preferred embodiment, drug conjugates of the present inventioncomprising anti-gp120 and other such anti-HIV antibodies can be used astherapeutics for HIV in AIDS patients; and drug conjugates of antibodiesto Mycobacterium tuberculosis are suitable as therapeutics fordrug-refractive tuberculosis. Fusion proteins of anti-gp120 antibody(anti HIV antibody) and a toxin, such as Pseudomonas exotoxin, have beenexamined for antiviral properties (Van Oigen et al., J Drug Target,5:75-91, 1998). Attempts at treating HIV infection in AIDS patientsfailed, possibly due to insufficient efficacy or unacceptable hosttoxicity. The drug conjugates of the present invention advantageouslylack such toxic side effects of protein toxins, and are thereforeadvantageously used in treating HIV infection in AIDS patients. Thesedrug conjugates can be given alone or in combination with otherantibiotics or therapeutic agents that are effective in such patientswhen given alone. Candidate anti-HIV antibodies include theanti-envelope antibody described by Johansson et al. (AIDS. 2006 Oct. 3;20(15):1911-5), as well as the anti-HIV antibodies described and sold byPolymun (Vienna, Austria), also described in U.S. Pat. No. 5,831,034,U.S. Pat. No. 5,911,989, and Vcelar et al., AIDS 2007; 21(16):2161-2170and Joos et al., Antimicrob. Agens Chemother. 2006; 50(5):1773-9, allincorporated herein by reference. A preferred targeting agent for HIV isvarious combinations of these antibodies in order to overcomeresistance.

In another preferred embodiment, diseases that may be treated using thetherapeutic conjugates of the preferred embodiments of the presentinvention include, but are not limited to immune dysregulation diseaseand related autoimmune diseases, including Class III autoimmune diseasessuch as immune-mediated thrombocytopenias, such as acute idiopathicthrombocytopenic purpura and chronic idiopathic thrombocytopenicpurpura, dermatomyositis, Sjögren's syndrome, multiple sclerosis,Sydenham's chorea, myasthenia gravis, systemic lupus erythematosus,lupus nephritis, rheumatic fever, polyglandular syndromes, bullouspemphigoid, diabetes mellitus, Henoch-Schonlein purpura,post-streptococcal nephritis, erythema nodosum, Takayasu's arteritis,Addison's disease, rheumatoid arthritis, sarcoidosis, ulcerativecolitis, erythema multiforme, IgA nephropathy, polyarteritis nodosa,ankylosing spondylitis, Goodpasture's syndrome, thromboangitisobliterans, Sjögren's syndrome, primary biliary cirrhosis, Hashimoto'sthyroiditis, thyrotoxicosis, scleroderma, chronic active hepatitis,rheumatoid arthritis, polymyositis/dermatomyositis, polychondritis,pemphigus vulgaris, Wegener's granulomatosis, membranous nephropathy,amyotrophic lateral sclerosis, tabes dorsalis, giant cellarteritis/polymyalgia, pernicious anemia, rapidly progressiveglomerulonephritis and fibrosing alveolitis, and also juvenile diabetes,as disclosed in U.S. Provisional Application Ser. No. 60/360,259, filedMar. 1, 2002 (now expired). Typical antibodies useful in these diseasesinclude, but are not limited to, those reactive with HLA-DR antigens,B-cell and plasma-cell antigens (e.g., CD19, CD20, CD21, CD22, CD23,CD4, CD5, CD8, CD14, CD15, CD19, CD20, CD21, CD22, CD23, CD25, CD33,CD37, CD38, CD40, CD40L, CD46, CD52, CD54, CD74, CD80, CD126, CD138, B7,MUC1, Ia, HM1.24, and HLA-DR), IL-6, IL-17. Since many of theseautoimmune diseases are affected by autoantibodies made by aberrantB-cell populations, depletion of these B-cells by therapeutic conjugatesinvolving such antibodies-therapeutic agent conjugates described hereinis a preferred method of autoimmune disease therapy, especially whenB-cell antibodies are combined, in certain circumstances, with HLA-DRantibodies and/or T-cell antibodies (including those which target IL-2as an antigen, such as anti-TAC antibody). In a preferred embodiment,the anti-B-cell, anti-T-cell, or anti-macrophage or other suchantibodies of use in the treatment of patients with autoimmune diseasesalso can be conjugated to result in more effective therapeutics tocontrol the host responses involved in said autoimmune diseases, and canbe given alone or in combination with other therapeutic agents, such asTNF inhibitors or TNF antibodies, unconjugated B- or T-cell antibodies,and the like.

In a preferred embodiment, a more effective incorporation into cells andpathogens can be accomplished by using multivalent, multispecific ormultivalent, monospecific antibodies. Examples of such bivalent andbispecific antibodies are found in U.S. Pat. Nos. 7,387,772; 7,300,655;7,238,785; and 7,282,567, the Examples section of each of which isincorporated herein by reference. These multivalent or multispecificantibodies are particularly preferred in the targeting of cancers andinfectious organisms (pathogens), which express multiple antigen targetsand even multiple epitopes of the same antigen target, but which oftenevade antibody targeting and sufficient binding for immunotherapybecause of insufficient expression or availability of a single antigentarget on the cell or pathogen. By targeting multiple antigens orepitopes, said antibodies show a higher binding and residence time onthe target, thus affording a higher saturation with the drug beingtargeted in this invention.

Methods of Administration

The subject molecules labeled with diagnostic or therapeutic agents maybe formulated to obtain compositions that include one or morepharmaceutically suitable excipients, one or more additionalingredients, or some combination of these. These can be accomplished byknown methods to prepare pharmaceutically useful dosages, whereby theactive ingredients (i.e., the labeled molecules) are combined in amixture with one or more pharmaceutically suitable excipients. Sterilephosphate-buffered saline is one example of a pharmaceutically suitableexcipient. Other suitable excipients are well known to those in the art.See, e.g., Ansel et al., PHARMACEUTICAL DOSAGE FORMS AND DRUG DELIVERYSYSTEMS, 5th Edition (Lea & Febiger 1990), and Gennaro (ed.),REMINGTON'S PHARMACEUTICAL SCIENCES, 18th Edition (Mack PublishingCompany 1990), and revised editions thereof.

The preferred route for administration of the compositions describedherein is parenteral injection. Injection may be intravenous,intraarterial, intralymphatic, intrathecal, or intracavitary (i.e.,parenterally). In parenteral administration, the compositions will beformulated in a unit dosage injectable form such as a solution,suspension or emulsion, in association with a pharmaceuticallyacceptable excipient. Such excipients are inherently nontoxic andnontherapeutic. Examples of such excipients are saline, Ringer'ssolution, dextrose solution and Hank's solution. Nonaqueous excipientssuch as fixed oils and ethyl oleate may also be used. A preferredexcipient is 5% dextrose in saline. The excipient may contain minoramounts of additives such as substances that enhance isotonicity andchemical stability, including buffers and preservatives. Other methodsof administration, including oral administration, are also contemplated.

Formulated compositions comprising labeled molecules can be used forintravenous administration via, for example, bolus injection orcontinuous infusion. Compositions for injection can be presented in unitdosage form, e.g., in ampoules or in multi-dose containers, with anadded preservative. Compositions can also take such forms assuspensions, solutions or emulsions in oily or aqueous vehicles, and cancontain formulatory agents such as suspending, stabilizing and/ordispersing agents. Alternatively, the compositions can be in powder formfor constitution with a suitable vehicle, e.g., sterile pyrogen-freewater, before use.

The compositions may be administered in solution. The pH of the solutionshould be in the range of pH 5 to 9.5, preferably pH 6.5 to 7.5. Theformulation thereof should be in a solution having a suitablepharmaceutically acceptable buffer such as phosphate, TRIS(hydroxymethyl) aminomethane-HCl or citrate and the like. Bufferconcentrations should be in the range of 1 to 100 mM. The formulatedsolution may also contain a salt, such as sodium chloride or potassiumchloride in a concentration of 50 to 150 mM. An effective amount of astabilizing agent such as mannitol, trehalose, sorbitol, glycerol,albumin, a globulin, a detergent, a gelatin, a protamine or a salt ofprotamine may also be included. The compositions may be administered toa mammal subcutaneously, intravenously, intramuscularly or by otherparenteral routes. Moreover, the administration may be by continuousinfusion or by single or multiple boluses.

Where bispecific antibodies are administered, for example in apretargeting technique, the dosage of an administered antibody forhumans will vary depending upon such factors as the patient's age,weight, height, sex, general medical condition and previous medicalhistory. Typically, it is desirable to provide the recipient with adosage of bispecific antibody that is in the range of from about 1 mg to200 mg as a single intravenous infusion, although a lower or higherdosage also may be administered as circumstances dictate. Typically, itis desirable to provide the recipient with a dosage that is in the rangeof from about 10 mg per square meter of body surface area or 17 to 18 mgof the antibody for the typical adult, although a lower or higher dosagealso may be administered as circumstances dictate. Examples of dosagesof bispecific antibodies that may be administered to a human subject are1 to 200 mg, more preferably 1 to 70 mg, most preferably 1 to 20 mg,although higher or lower doses may be used. Dosages of therapeuticbispecific antibodies may be higher, such as 1 to 200, 1 to 100, 100 to1000, 100 to 500, 200 to 750 mg or any range in between.

In general, the dosage of labeled molecule(s) to administer will varydepending upon such factors as the patient's age, weight, height, sex,general medical condition and previous medical history. Preferably, asaturating dose of the labeled molecules is administered to a patient.For administration of radiolabeled molecules, the dosage may be measuredby millicuries.

In preferred embodiments, the labeled peptides, proteins and/orantibodies are of use for therapy of cancer. Examples of cancersinclude, but are not limited to, carcinoma, lymphoma, blastoma, sarcoma,and leukemia or lymphoid malignancies. More particular examples of suchcancers are noted below and include: squamous cell cancer (e.g.epithelial squamous cell cancer), lung cancer including small-cell lungcancer, non-small cell lung cancer, adenocarcinoma of the lung andsquamous carcinoma of the lung, cancer of the peritoneum, hepatocellularcancer, gastric or stomach cancer including gastrointestinal cancer,pancreatic cancer, glioblastoma, cervical cancer, ovarian cancer, livercancer, bladder cancer, hepatoma, breast cancer, colon cancer, rectalcancer, colorectal cancer, endometrial cancer or uterine carcinoma,salivary gland carcinoma, kidney or renal cancer, prostate cancer,vulval cancer, thyroid cancer, hepatic carcinoma, anal carcinoma, penilecarcinoma, as well as head and neck cancer. The term “cancer” includesprimary malignant cells or tumors (e.g., those whose cells have notmigrated to sites in the subject's body other than the site of theoriginal malignancy or tumor) and secondary malignant cells or tumors(e.g., those arising from metastasis, the migration of malignant cellsor tumor cells to secondary sites that are different from the site ofthe original tumor).

Other examples of cancers or malignancies include, but are not limitedto: Acute Childhood Lymphoblastic Leukemia, Acute LymphoblasticLeukemia, Acute Lymphocytic Leukemia, Acute Myeloid Leukemia,Adrenocortical Carcinoma, Adult (Primary) Hepatocellular Cancer, Adult(Primary) Liver Cancer, Adult Acute Lymphocytic Leukemia, Adult AcuteMyeloid Leukemia, Adult Hodgkin's Disease, Adult Hodgkin's Lymphoma,Adult Lymphocytic Leukemia, Adult Non-Hodgkin's Lymphoma, Adult PrimaryLiver Cancer, Adult Soft Tissue Sarcoma, AIDS-Related Lymphoma,AIDS-Related Malignancies, Anal Cancer, Astrocytoma, Bile Duct Cancer,Bladder Cancer, Bone Cancer, Brain Stem Glioma, Brain Tumors, BreastCancer, Cancer of the Renal Pelvis and Ureter, Central Nervous System(Primary) Lymphoma, Central Nervous System Lymphoma, CerebellarAstrocytoma, Cerebral Astrocytoma, Cervical Cancer, Childhood (Primary)Hepatocellular Cancer, Childhood (Primary) Liver Cancer, Childhood AcuteLymphoblastic Leukemia, Childhood Acute Myeloid Leukemia, ChildhoodBrain Stem Glioma, Childhood Cerebellar Astrocytoma, Childhood CerebralAstrocytoma, Childhood Extracranial Germ Cell Tumors, ChildhoodHodgkin's Disease, Childhood Hodgkin's Lymphoma, Childhood Hypothalamicand Visual Pathway Glioma, Childhood Lymphoblastic Leukemia, ChildhoodMedulloblastoma, Childhood Non-Hodgkin's Lymphoma, Childhood Pineal andSupratentorial Primitive Neuroectodermal Tumors, Childhood Primary LiverCancer, Childhood Rhabdomyosarcoma, Childhood Soft Tissue Sarcoma,Childhood Visual Pathway and Hypothalamic Glioma, Chronic LymphocyticLeukemia, Chronic Myelogenous Leukemia, Colon Cancer, Cutaneous T-CellLymphoma, Endocrine Pancreas Islet Cell Carcinoma, Endometrial Cancer,Ependymoma, Epithelial Cancer, Esophageal Cancer, Ewing's Sarcoma andRelated Tumors, Exocrine Pancreatic Cancer, Extracranial Germ CellTumor, Extragonadal Germ Cell Tumor, Extrahepatic Bile Duct Cancer, EyeCancer, Female Breast Cancer, Gaucher's Disease, Gallbladder Cancer,Gastric Cancer, Gastrointestinal Carcinoid Tumor, GastrointestinalTumors, Germ Cell Tumors, Gestational Trophoblastic Tumor, Hairy CellLeukemia, Head and Neck Cancer, Hepatocellular Cancer, Hodgkin'sDisease, Hodgkin's Lymphoma, Hypergammaglobulinemia, HypopharyngealCancer, Intestinal Cancers, Intraocular Melanoma, Islet Cell Carcinoma,Islet Cell Pancreatic Cancer, Kaposi's Sarcoma, Kidney Cancer, LaryngealCancer, Lip and Oral Cavity Cancer, Liver Cancer, Lung Cancer,Lymphoproliferative Disorders, Macroglobulinemia, Male Breast Cancer,Malignant Mesothelioma, Malignant Thymoma, Medulloblastoma, Melanoma,Mesothelioma, Metastatic Occult Primary Squamous Neck Cancer, MetastaticPrimary Squamous Neck Cancer, Metastatic Squamous Neck Cancer, MultipleMyeloma, Multiple Myeloma/Plasma Cell Neoplasm, MyelodysplasticSyndrome, Myelogenous Leukemia, Myeloid Leukemia, MyeloproliferativeDisorders, Nasal Cavity and Paranasal Sinus Cancer, NasopharyngealCancer, Neuroblastoma, Non-Hodgkin's Lymphoma During Pregnancy,Nonmelanoma Skin Cancer, Non-Small Cell Lung Cancer, Occult PrimaryMetastatic Squamous Neck Cancer, Oropharyngeal Cancer, Osteo-/MalignantFibrous Sarcoma, Osteosarcoma/Malignant Fibrous Histiocytoma,Osteosarcoma/Malignant Fibrous Histiocytoma of Bone, Ovarian EpithelialCancer, Ovarian Germ Cell Tumor, Ovarian Low Malignant Potential Tumor,Pancreatic Cancer, Paraproteinemias, Purpura, Parathyroid Cancer, PenileCancer, Pheochromocytoma, Pituitary Tumor, Plasma Cell Neoplasm/MultipleMyeloma, Primary Central Nervous System Lymphoma, Primary Liver Cancer,Prostate Cancer, Rectal Cancer, Renal Cell Cancer, Renal Pelvis andUreter Cancer, Retinoblastoma, Rhabdomyosarcoma, Salivary Gland Cancer,Sarcoidosis Sarcomas, Sezary Syndrome, Skin Cancer, Small Cell LungCancer, Small Intestine Cancer, Soft Tissue Sarcoma, Squamous NeckCancer, Stomach Cancer, Supratentorial Primitive Neuroectodermal andPineal Tumors, T-Cell Lymphoma, Testicular Cancer, Thymoma, ThyroidCancer, Transitional Cell Cancer of the Renal Pelvis and Ureter,Transitional Renal Pelvis and Ureter Cancer, Trophoblastic Tumors,Ureter and Renal Pelvis Cell Cancer, Urethral Cancer, Uterine Cancer,Uterine Sarcoma, Vaginal Cancer, Visual Pathway and Hypothalamic Glioma,Vulvar Cancer, Waldenstrom's Macroglobulinemia, Wilms' Tumor, and anyother hyperproliferative disease, besides neoplasia, located in an organsystem listed above.

The methods and compositions described and claimed herein may be used todetect or treat malignant or premalignant conditions. Such uses areindicated in conditions known or suspected of preceding progression toneoplasia or cancer, in particular, where non-neoplastic cell growthconsisting of hyperplasia, metaplasia, or most particularly, dysplasiahas occurred (for review of such abnormal growth conditions, see Robbinsand Angell, Basic Pathology, 2d Ed., W. B. Saunders Co., Philadelphia,pp. 68-79 (1976)).

Dysplasia is frequently a forerunner of cancer, and is found mainly inthe epithelia. It is the most disorderly form of non-neoplastic cellgrowth, involving a loss in individual cell uniformity and in thearchitectural orientation of cells. Dysplasia characteristically occurswhere there exists chronic irritation or inflammation. Dysplasticdisorders which can be detected include, but are not limited to,anhidrotic ectodermal dysplasia, anterofacial dysplasia, asphyxiatingthoracic dysplasia, atriodigital dysplasia, bronchopulmonary dysplasia,cerebral dysplasia, cervical dysplasia, chondroectodermal dysplasia,cleidocranial dysplasia, congenital ectodermal dysplasia,craniodiaphysial dysplasia, craniocarpotarsal dysplasia,craniometaphysial dysplasia, dentin dysplasia, diaphysial dysplasia,ectodermal dysplasia, enamel dysplasia, encephalo-ophthalmic dysplasia,dysplasia epiphysialis hemimelia, dysplasia epiphysialis multiplex,dysplasia epiphysialis punctata, epithelial dysplasia,faciodigitogenital dysplasia, familial fibrous dysplasia of jaws,familial white folded dysplasia, fibromuscular dysplasia, fibrousdysplasia of bone, florid osseous dysplasia, hereditary renal-retinaldysplasia, hidrotic ectodermal dysplasia, hypohidrotic ectodermaldysplasia, lymphopenic thymic dysplasia, mammary dysplasia,mandibulofacial dysplasia, metaphysial dysplasia, Mondini dysplasia,monostotic fibrous dysplasia, mucoepithelial dysplasia, multipleepiphysial dysplasia, oculoauriculovertebral dysplasia,oculodentodigital dysplasia, oculovertebral dysplasia, odontogenicdysplasia, opthalmomandibulomelic dysplasia, periapical cementaldysplasia, polyostotic fibrous dysplasia, pseudoachondroplasticspondyloepiphysial dysplasia, retinal dysplasia, septo-optic dysplasia,spondyloepiphysial dysplasia, and ventriculoradial dysplasia.

Additional pre-neoplastic disorders which can be detected and/or treatedinclude, but are not limited to, benign dysproliferative disorders(e.g., benign tumors, fibrocystic conditions, tissue hypertrophy,intestinal polyps, colon polyps, and esophageal dysplasia), leukoplakia,keratoses, Bowen's disease, Farmer's Skin, solar cheilitis, and solarkeratosis.

Additional hyperproliferative diseases, disorders, and/or conditionsinclude, but are not limited to, progression, and/or metastases ofmalignancies and related disorders such as leukemia (including acuteleukemias (e.g., acute lymphocytic leukemia, acute myelocytic leukemia(including myeloblastic, promyelocytic, myelomonocytic, monocytic, anderythroleukemia)) and chronic leukemias (e.g., chronic myelocytic(granulocytic) leukemia and chronic lymphocytic leukemia)), polycythemiavera, lymphomas (e.g., Hodgkin's disease and non-Hodgkin's disease),multiple myeloma, Waldenstrom's macroglobulinemia, heavy chain disease,and solid tumors including, but not limited to, sarcomas and carcinomassuch as fibrosarcoma, myxosarcoma, liposarcoma, chondrosarcoma,osteogenic sarcoma, chordoma, angiosarcoma, endotheliosarcoma,lymphangiosarcoma, lymphangioendotheliosarcoma, synovioma, mesothelioma,Ewing's tumor, leiomyosarcoma, rhabdomyosarcoma, colon carcinoma,pancreatic cancer, breast cancer, ovarian cancer, prostate cancer,squamous cell carcinoma, basal cell carcinoma, adenocarcinoma, sweatgland carcinoma, sebaceous gland carcinoma, papillary carcinoma,papillary adenocarcinomas, cystadenocarcinoma, medullary carcinoma,bronchogenic carcinoma, renal cell carcinoma, hepatoma, bile ductcarcinoma, choriocarcinoma, seminoma, embryonal carcinoma, Wilm's tumor,cervical cancer, testicular tumor, lung carcinoma, small cell lungcarcinoma, bladder carcinoma, epithelial carcinoma, glioma, astrocytoma,medulloblastoma, craniopharyngioma, ependymoma, pinealoma,emangioblastoma, acoustic neuroma, oligodendroglioma, menangioma,melanoma, neuroblastoma, and retinoblastoma.

The exemplary conditions listed above that may be treated are notlimiting. The skilled artisan will be aware that antibodies, antibodyfragments or targeting peptides are known for a wide variety ofconditions, such as autoimmune disease, graft-versus-host-disease, organtransplant rejection, cardiovascular disease, neurodegenerative disease,metabolic disease, cancer, infectious disease and hyperproliferativedisease.

Exemplary autoimmune diseases include acute idiopathic thrombocytopenicpurpura, chronic idiopathic thrombocytopenic purpura, dermatomyositis,Sydenham's chorea, myasthenia gravis, systemic lupus erythematosus,lupus nephritis, rheumatic fever, polyglandular syndromes, bullouspemphigoid, juvenile diabetes mellitus, Henoch-Schonlein purpura,post-streptococcal nephritis, erythema nodosum, Takayasu's arteritis,Addison's disease, rheumatoid arthritis, multiple sclerosis,sarcoidosis, ulcerative colitis, erythema multiforme, IgA nephropathy,polyarteritis nodosa, ankylosing spondylitis, Goodpasture's syndrome,thromboangitis obliterans, Sjogren's syndrome, primary biliarycirrhosis, Hashimoto's thyroiditis, thyrotoxicosis, scleroderma, chronicactive hepatitis, polymyositis/dermatomyositis, polychondritis,pemphigus vulgaris, Wegener's granulomatosis, membranous nephropathy,amyotrophic lateral sclerosis, tabes dorsalis, giant cellarteritis/polymyalgia, pernicious anemia, rapidly progressiveglomerulonephritis, psoriasis and fibrosing alveolitis.

Kits

Various embodiments may concern kits containing components suitable fortreating diseased tissue in a patient. Exemplary kits may contain atleast one conjugated antibody or other targeting moiety as describedherein. If the composition containing components for administration isnot formulated for delivery via the alimentary canal, such as by oraldelivery, a device capable of delivering the kit components through someother route may be included. One type of device, for applications suchas parenteral delivery, is a syringe that is used to inject thecomposition into the body of a subject. Inhalation devices may also beused.

The kit components may be packaged together or separated into two ormore containers. In some embodiments, the containers may be vials thatcontain sterile, lyophilized formulations of a composition that aresuitable for reconstitution. A kit may also contain one or more bufferssuitable for reconstitution and/or dilution of other reagents. Othercontainers that may be used include, but are not limited to, a pouch,tray, box, tube, or the like. Kit components may be packaged andmaintained sterilely within the containers. Another component that canbe included is instructions to a person using a kit for its use.

EXAMPLES

Various embodiments of the present invention are illustrated by thefollowing examples, without limiting the scope thereof.

Example 1 Preparation of Dock-and-Lock (DNL) Constructs

DDD and AD Fusion Proteins

The DNL technique can be used to make dimers, trimers, tetramers,hexamers, etc. comprising virtually any antibody, antibody fragment, orother effector moiety. For certain preferred embodiments, the antibodiesand antibody fragments may be produced as fusion proteins comprisingeither a dimerization and docking domain (DDD) or anchoring domain (AD)sequence. However, the skilled artisan will realize that other methodsof conjugation exist, such as chemical cross-linking, click chemistryreaction, etc.

The technique is not limiting and any protein or peptide of use may beproduced as an AD or DDD fusion protein for incorporation into a DNLconstruct. Where chemical cross-linking is utilized, the AD and DDDconjugates may comprise any molecule that may be cross-linked to an ADor DDD sequence using any cross-linking technique known in the art. Incertain exemplary embodiments, a dendrimer or other polymeric moietysuch as polyethylene glycol (PEG) may be incorporated into a DNLconstruct, as described in further detail below.

For different types of DNL constructs, different AD or DDD sequences maybe utilized. Exemplary DDD and AD sequences are provided below.

DDD1: (SEQ ID NO: 33) SHIQIPPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA DDD2:(SEQ ID NO: 34) CGHIQIPPGLTELLQGYTVEVLRQQPPLVEFAVEYFTRLREARA AD1:(SEQ ID NO: 35) QIEYLAKQIVDNAIQQA AD2: (SEQ ID NO: 36)CGQIEYLAKQIVDNAIQQAGC

The skilled artisan will realize that DDD1 and DDD2 comprise the DDDsequence of the human RIIα form of protein kinase A. However, inalternative embodiments, the DDD and AD moieties may be based on the DDDsequence of the human RIα form of protein kinase A and a correspondingAKAP sequence, as exemplified in DDD3, DDD3C and AD3 below.

DDD3 (SEQ ID NO: 37) SLRECELYVQKHNIQALLKDSIVQLCTARPERPMAFLREYFERLEKEEAKDDD3C (SEQ ID NO: 38) MSCGGSLRECELYVQKHNIQALLKDSIVQLCTARPERPMAFLREYFERLEKEEAK AD3 (SEQ ID NO: 39) CGFEELAWKIAKMIWSDVFQQGC

Expression Vectors

The plasmid vector pdHL2 has been used to produce a number of antibodiesand antibody-based constructs. See Gillies et al., J Immunol Methods(1989), 125:191-202; Losman et al., Cancer (Phila) (1997), 80:2660-6.The di-cistronic mammalian expression vector directs the synthesis ofthe heavy and light chains of IgG. The vector sequences are mostlyidentical for many different IgG-pdHL2 constructs, with the onlydifferences existing in the variable domain (VH and VL) sequences. Usingmolecular biology tools known to those skilled in the art, these IgGexpression vectors can be converted into Fab-DDD or Fab-AD expressionvectors. To generate Fab-DDD expression vectors, the coding sequencesfor the hinge, CH2 and CH3 domains of the heavy chain are replaced witha sequence encoding the first 4 residues of the hinge, a 14 residueGly-Ser linker and the first 44 residues of human RIIα (referred to asDDD1). To generate Fab-AD expression vectors, the sequences for thehinge, CH2 and CH3 domains of IgG are replaced with a sequence encodingthe first 4 residues of the hinge, a 15 residue Gly-Ser linker and a 17residue synthetic AD called AKAP-IS (referred to as AD1), which wasgenerated using bioinformatics and peptide array technology and shown tobind RIIα dimers with a very high affinity (0.4 nM). See Alto, et al.Proc. Natl. Acad. Sci., U.S.A (2003), 100:4445-50.

Two shuttle vectors were designed to facilitate the conversion ofIgG-pdHL2 vectors to either Fab-DDD1 or Fab-AD1 expression vectors, asdescribed below.

Preparation of CH1

The CH1 domain was amplified by PCR using the pdHL2 plasmid vector as atemplate. The left PCR primer consisted of the upstream (5′) end of theCH1 domain and a SacII restriction endonuclease site, which is 5′ of theCH1 coding sequence. The right primer consisted of the sequence codingfor the first 4 residues of the hinge (PKSC) followed by four glycinesand a serine, with the final two codons (GS) comprising a Bam HIrestriction site. The 410 bp PCR amplimer was cloned into the PGEMT® PCRcloning vector (PROMEGA®, Inc.) and clones were screened for inserts inthe T7 (5′) orientation.

A duplex oligonucleotide was synthesized to code for the amino acidsequence of DDD1 preceded by 11 residues of the linker peptide, with thefirst two codons comprising a BamHI restriction site. A stop codon andan EagI restriction site are appended to the 3′end. The encodedpolypeptide sequence is shown below.

(SEQ ID NO: 40) GSGGGGSGGGGSHIQIPPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRL REARA

Two oligonucleotides, designated RIIA1-44 top and RIIA1-44 bottom, whichoverlap by 30 base pairs on their 3′ ends, were synthesized and combinedto comprise the central 154 base pairs of the 174 bp DDD1 sequence. Theoligonucleotides were annealed and subjected to a primer extensionreaction with Taq polymerase. Following primer extension, the duplex wasamplified by PCR. The amplimer was cloned into PGEMT® and screened forinserts in the T7 (5′) orientation.

A duplex oligonucleotide was synthesized to code for the amino acidsequence of AD1 preceded by 11 residues of the linker peptide with thefirst two codons comprising a BamHI restriction site. A stop codon andan EagI restriction site are appended to the 3′end. The encodedpolypeptide sequence is shown below.

GSGGGGSGGGGSQIEYLAKQIVDNAIQQA (SEQ ID NO: 41)

Two complimentary overlapping oligonucleotides encoding the abovepeptide sequence, designated AKAP-IS Top and AKAP-IS Bottom, weresynthesized and annealed. The duplex was amplified by PCR. The amplimerwas cloned into the PGEMT® vector and screened for inserts in the T7(5′) orientation.

Ligating DDD1 with CH1

A 190 bp fragment encoding the DDD1 sequence was excised from PGEMT®with BamHI and NotI restriction enzymes and then ligated into the samesites in CH1-PGEMT® to generate the shuttle vector CH1-DDD1-PGEMT®.

Ligating AD1 with CH1

A 110 bp fragment containing the AD1 sequence was excised from PGEMT®with BamHI and NotI and then ligated into the same sites in CH1-PGEMT®to generate the shuttle vector CH1-AD1-PGEMT®.

Cloning CH1-DDD1 or CH1-AD1 into pdHL2-Based Vectors

With this modular design either CH1-DDD1 or CH1-AD1 can be incorporatedinto any IgG construct in the pdHL2 vector. The entire heavy chainconstant domain is replaced with one of the above constructs by removingthe SacII/EagI restriction fragment (CH1-CH3) from pdHL2 and replacingit with the SacII/EagI fragment of CH1-DDD1 or CH1-AD1, which is excisedfrom the respective pGemT shuttle vector.

Construction of h679-Fd-AD1-pdHL2h

679-Fd-AD-pdHL2 is an expression vector for production of h679 Fab withAD1 coupled to the carboxyl terminal end of the CH1 domain of the Fd viaa flexible Gly/Ser peptide spacer composed of 14 amino acid residues. ApdHL2-based vector containing the variable domains of h679 was convertedto h679-Fd-AD1-pdHL2 by replacement of the SacII/EagI fragment with theCH1-AD1 fragment, which was excised from the CH1-AD1-SV3 shuttle vectorwith SacII and EagI.

Construction of C-DDD1-Fd-hMN-14-pdHL2

C-DDD1-Fd-hMN-14-pdHL2 is an expression vector for production of astable dimer that comprises two copies of a fusion proteinC-DDD1-Fab-hMN-14, in which DDD1 is linked to hMN-14 Fab at the carboxylterminus of CH1 via a flexible peptide spacer. The plasmid vectorhMN-14(I)-pdHL2, which has been used to produce hMN-14 IgG, wasconverted to C-DDD1-Fd-hMN-14-pdHL2 by digestion with SacII and EagIrestriction endonucleases to remove the CH1-CH3 domains and insertion ofthe CH1-DDD1 fragment, which was excised from the CH1-DDD1-SV3 shuttlevector with SacII and EagI.

The same technique has been utilized to produce plasmids for Fabexpression of a wide variety of known antibodies, such as hLL1, hLL2,hPAM4, hR1, hRS7, hMN-14, hMN-15, hA19, hA20 and many others. Generally,the antibody variable region coding sequences were present in a pdHL2expression vector and the expression vector was converted for productionof an AD- or DDD-fusion protein as described above. The AD- andDDD-fusion proteins comprising a Fab fragment of any of such antibodiesmay be combined, in an approximate ratio of two DDD-fusion proteins perone AD-fusion protein, to generate a trimeric DNL construct comprisingtwo Fab fragments of a first antibody and one Fab fragment of a secondantibody.

Construction of N-DDD1-Fd-hMN-14-pdHL2

N-DDD1-Fd-hMN-14-pdHL2 is an expression vector for production of astable dimer that comprises two copies of a fusion proteinN-DDD-Fab-hMN-14, in which DDD1 is linked to hMN-14 Fab at the aminoterminus of VH via a flexible peptide spacer. The expression vector wasengineered as follows. The DDD1 domain was amplified by PCR.

As a result of the PCR, an NcoI restriction site and the coding sequencefor part of the linker containing a BamHI restriction were appended tothe 5′ and 3′ ends, respectively. The 170 bp PCR amplimer was clonedinto the pGemT vector and clones were screened for inserts in the T7(5′) orientation. The 194 bp insert was excised from the pGemT vectorwith NcoI and Sail restriction enzymes and cloned into the SV3 shuttlevector, which was prepared by digestion with those same enzymes, togenerate the intermediate vector DDD1-SV3.

The hMN-14 Fd sequence was amplified by PCR. As a result of the PCR, aBamHI restriction site and the coding sequence for part of the linkerwere appended to the 5′ end of the amplimer. A stop codon and EagIrestriction site was appended to the 3′ end. The 1043 bp amplimer wascloned into pGemT. The hMN-14-Fd insert was excised from pGemT withBamHI and EagI restriction enzymes and then ligated with DDD1-SV3vector, which was prepared by digestion with those same enzymes, togenerate the construct N-DDD1-hMN-14Fd-SV3.

The N-DDD1-hMN-14 Fd sequence was excised with XhoI and EagI restrictionenzymes and the 1.28 kb insert fragment was ligated with a vectorfragment that was prepared by digestion of C-hMN-14-pdHL2 with thosesame enzymes. The final expression vector was N-DDD1-Fd-hMN-14-pDHL2.The N-linked Fab fragment exhibited similar DNL complex formation andantigen binding characteristics as the C-linked Fab fragment (notshown).

C-DDD2-Fd-hMN-14-pdHL2

C-DDD2-Fd-hMN-14-pdHL2 is an expression vector for production ofC-DDD2-Fab-hMN-14, which possesses a dimerization and docking domainsequence of DDD2 appended to the carboxyl terminus of the Fd of hMN-14via a 14 amino acid residue Gly/Ser peptide linker. The fusion proteinsecreted is composed of two identical copies of hMN-14 Fab held togetherby non-covalent interaction of the DDD2 domains.

The expression vector was engineered as follows. Two overlapping,complimentary oligonucleotides, which comprise the coding sequence forpart of the linker peptide and residues 1-13 of DDD2, were madesynthetically. The oligonucleotides were annealed and phosphorylatedwith T4 PNK, resulting in overhangs on the 5′ and 3′ ends that arecompatible for ligation with DNA digested with the restrictionendonucleases BamHI and PstI, respectively.

The duplex DNA was ligated with the shuttle vector CH1-DDD1-PGEMT®,which was prepared by digestion with BamHI and PstI, to generate theshuttle vector CH1-DDD2-PGEMT@. A 507 bp fragment was excised fromCH1-DDD2-PGEMT@ with SacII and EagI and ligated with the IgG expressionvector hMN-14(I)-pdHL2, which was prepared by digestion with SacII andEagI. The final expression construct was designatedC-DDD2-Fd-hMN-14-pdHL2. Similar techniques have been utilized togenerated DDD2-fusion proteins of the Fab fragments of a number ofdifferent humanized antibodies.

h679-Fd-AD2-pdHL2

h679-Fab-AD2, was designed to pair as B to C-DDD2-Fab-hMN-14 as A.h679-Fd-AD2-pdHL2 is an expression vector for the production ofh679-Fab-AD2, which possesses an anchoring domain sequence of AD2appended to the carboxyl terminal end of the CH1 domain via a 14 aminoacid residue Gly/Ser peptide linker. AD2 has one cysteine residuepreceding and another one following the anchor domain sequence of AD1.

The expression vector was engineered as follows. Two overlapping,complimentary oligonucleotides (AD2 Top and AD2 Bottom), which comprisethe coding sequence for AD2 and part of the linker sequence, were madesynthetically. The oligonucleotides were annealed and phosphorylatedwith T4 PNK, resulting in overhangs on the 5′ and 3′ ends that arecompatible for ligation with DNA digested with the restrictionendonucleases BamHI and SpeI, respectively.

The duplex DNA was ligated into the shuttle vector CH1-AD1-PGEMT®, whichwas prepared by digestion with BamHI and SpeI, to generate the shuttlevector CH1-AD2-PGEMT®. A 429 base pair fragment containing CH1 and AD2coding sequences was excised from the shuttle vector with SacII and EagIrestriction enzymes and ligated into h679-pdHL2 vector that prepared bydigestion with those same enzymes. The final expression vector ish679-Fd-AD2-pdHL2.

Example 2 Generation of TF1 DNL Construct

A large scale preparation of a DNL construct, referred to as TF1, wascarried out as follows. N-DDD2-Fab-hMN-14 (Protein L-purified) andh679-Fab-AD2 (IMP-291-purified) were first mixed in roughlystoichiometric concentrations in 1 mM EDTA, PBS, pH 7.4. Before theaddition of TCEP, SE-HPLC did not show any evidence of a₂b formation(not shown). Instead there were peaks representing a₄ (7.97 min; 200kDa), a₂ (8.91 min; 100 kDa) and B (10.01 min; 50 kDa). Addition of 5 mMTCEP rapidly resulted in the formation of the a₂b complex asdemonstrated by a new peak at 8.43 min, consistent with a 150 kDaprotein (not shown). Apparently there was excess B in this experiment asa peak attributed to h679-Fab-AD2 (9.72 min) was still evident yet noapparent peak corresponding to either a₂ or a₄ was observed. Afterreduction for one hour, the TCEP was removed by overnight dialysisagainst several changes of PBS. The resulting solution was brought to10% DMSO and held overnight at room temperature.

When analyzed by SE-HPLC, the peak representing a₂b appeared to besharper with a slight reduction of the retention time by 0.1 min to 8.31min (not shown), which, based on our previous findings, indicates anincrease in binding affinity. The complex was further purified byIMP-291 affinity chromatography to remove the kappa chain contaminants.As expected, the excess h679-AD2 was co-purified and later removed bypreparative SE-HPLC (not shown).

TF1 is a highly stable complex. When TF1 was tested for binding to anHSG (IMP-239) sensorchip, there was no apparent decrease of the observedresponse at the end of sample injection. In contrast, when a solutioncontaining an equimolar mixture of both C-DDD1-Fab-hMN-14 andh679-Fab-AD1 was tested under similar conditions, the observed increasein response units was accompanied by a detectable drop during andimmediately after sample injection, indicating that the initially formeda₂b structure was unstable. Moreover, whereas subsequent injection ofWI2 gave a substantial increase in response units for TF1, no increasewas evident for the C-DDD1/AD1 mixture.

The additional increase of response units resulting from the binding ofWI2 to TF1 immobilized on the sensorchip corresponds to two fullyfunctional binding sites, each contributed by one subunit ofN-DDD2-Fab-hMN-14. This was confirmed by the ability of TF1 to bind twoFab fragments of WI2 (not shown). When a mixture containing h679-AD2 andN-DDD1-hMN4, which had been reduced and oxidized exactly as TF1, wasanalyzed by BIAcore, there was little additional binding of WI2 (notshown), indicating that a disulfide-stabilized a₂b complex such as TF1could only form through the interaction of DDD2 and AD2.

Two improvements to the process were implemented to reduce the time andefficiency of the process. First, a slight molar excess ofN-DDD2-Fab-hMN-14 present as a mixture of a₄/a₂ structures was used toreact with h679-Fab-AD2 so that no free h679-Fab-AD2 remained and anya₄/a₂ structures not tethered to h679-Fab-AD2, as well as light chains,would be removed by IMP-291 affinity chromatography. Second, hydrophobicinteraction chromatography (HIC) has replaced dialysis or diafiltrationas a means to remove TCEP following reduction, which would not onlyshorten the process time but also add a potential viral removing step.N-DDD2-Fab-hMN-14 and 679-Fab-AD2 were mixed and reduced with 5 mM TCEPfor 1 hour at room temperature. The solution was brought to 0.75 Mammonium sulfate and then loaded onto a Butyl FF HIC column. The columnwas washed with 0.75 M ammonium sulfate, 5 mM EDTA, PBS to remove TCEP.The reduced proteins were eluted from the HIC column with PBS andbrought to 10% DMSO. Following incubation at room temperature overnight,highly purified TF1 was isolated by IMP-291 affinity chromatography (notshown). No additional purification steps, such as gel filtration, wererequired.

Example 3 Generation of TF2 DNL Construct

A trimeric DNL construct designated TF2 was obtained by reactingC-DDD2-Fab-hMN-14 with h679-Fab-AD2. A pilot batch of TF2 was generatedwith >90% yield as follows. Protein L-purified C-DDD2-Fab-hMN-14 (200mg) was mixed with h679-Fab-AD2 (60 mg) at a 1.4:1 molar ratio. Thetotal protein concentration was 1.5 mg/ml in PBS containing 1 mM EDTA.Subsequent steps involved TCEP reduction, HIC chromatography, DMSOoxidation, and IMP 291 affinity chromatography. Before the addition ofTCEP, SE-HPLC did not show any evidence of a₂b formation. Addition of 5mM TCEP rapidly resulted in the formation of a₂b complex consistent witha 157 kDa protein expected for the binary structure. TF2 was purified tonear homogeneity by IMP 291 affinity chromatography (not shown). IMP 291is a synthetic peptide containing the HSG hapten to which the 679 Fabbinds (Rossi et al., 2005, Clin Cancer Res 11:7122s-29s). SE-HPLCanalysis of the IMP 291 unbound fraction demonstrated the removal of a₄,a₂ and free kappa chains from the product (not shown).

The functionality of TF2 was determined by BIACORE® assay. TF2,C-DDD1-hMN-14+h679-AD1 (used as a control sample of noncovalent a₂bcomplex), or C-DDD2-hMN-14+h679-AD2 (used as a control sample ofunreduced a₂ and b components) were diluted to 1 μg/ml (total protein)and passed over a sensorchip immobilized with HSG. The response for TF2was approximately two-fold that of the two control samples, indicatingthat only the h679-Fab-AD component in the control samples would bind toand remain on the sensorchip. Subsequent injections of WI2 IgG, ananti-idiotype antibody for hMN-14, demonstrated that only TF2 had aDDD-Fab-hMN-14 component that was tightly associated with h679-Fab-AD asindicated by an additional signal response. The additional increase ofresponse units resulting from the binding of WI2 to TF2 immobilized onthe sensorchip corresponded to two fully functional binding sites, eachcontributed by one subunit of C-DDD2-Fab-hMN-14. This was confirmed bythe ability of TF2 to bind two Fab fragments of WI2 (not shown).

Example 4 Production of TF10 Bispecific Antibody

A similar protocol was used to generate a trimeric TF10 DNL construct,comprising two copies of a C-DDD2-Fab-hPAM4 and one copy ofC-AD2-Fab-679. The cancer-targeting antibody component in TF10 wasderived from hPAM4, a humanized anti-pancreatic cancer mucin MAb thathas been studied in detail as a radiolabeled MAb (e.g., Gold et al.,Clin. Cancer Res. 13: 7380-7387, 2007). The hapten-binding component wasderived from h679, a humanized anti-histaminyl-succinyl-glycine (HSG)MAb. The TF10 bispecific ([hPAM4]₂×h679) antibody was produced using themethod disclosed for production of the (anti CEA)₂×anti HSG bsAb TF2, asdescribed above. The TF10 construct bears two humanized PAM4 Fabs andone humanized 679 Fab.

The two fusion proteins (hPAM4-DDD and h679-AD2) were expressedindependently in stably transfected myeloma cells. The tissue culturesupernatant fluids were combined, resulting in a two-fold molar excessof hPAM4-DDD. The reaction mixture was incubated at room temperature for24 hours under mild reducing conditions using 1 mM reduced glutathione.Following reduction, the DNL reaction was completed by mild oxidationusing 2 mM oxidized glutathione. TF1O was isolated by affinitychromatography using IMP 291-affigel resin, which binds with highspecificity to the h679 Fab.

The skilled artisan will realize that the DNL techniques disclosed abovemay be used to produce complexes comprising any combination ofantibodies, immunoconjugates, or other effector moieties that may beattached to an AD or DDD moiety.

Example 5 Production of AD- and DDD-Linked Fab and IgG Fusion Proteinsfrom Multiple Antibodies

Using the techniques described in the preceding Examples, the IgG andFab fusion proteins shown in Table 2 were constructed and incorporatedinto DNL constructs. The fusion proteins retained the antigen-bindingcharacteristics of the parent antibodies and the DNL constructsexhibited the antigen-binding activities of the incorporated antibodiesor antibody fragments.

Example 6 Sequence Variants for DNL

In certain preferred embodiments, the AD and DDD sequences incorporatedinto the DNL construct comprise the amino acid sequences of AD1, AD2,AD3, DDD1, DDD2, DDD3 or DDD3C as discussed above. However, inalternative embodiments sequence variants of AD and/or DDD moieties maybe utilized in construction of the DNL complexes. For example, there areonly four variants of human PKA DDD sequences, corresponding to the DDDmoieties of PKA RIα, RIIα, RIβ and RIIβ. The RIIα DDD sequence is thebasis of DDD1 and DDD2 disclosed above. The four human PKA DDD sequencesare shown below. The DDD sequence represents residues 1-44 of RIIα, 1-44of RIIβ, 12-61 of RIα and 13-66 of RIβ. (Note that the sequence of DDD1is modified slightly from the human PKA RIIα DDD moiety.)

PKA RIα

SLRECELYVQKHNIQALLKDVSIVQLCTARPERPMAFLREYFEKLEKEEAK (SEQ ID NO:42)

TABLE 2 Fusion proteins comprising IgG or Fab Fusion Protein BindingSpecificity C-AD1-Fab-h679 HSG C-AD2-Fab-h679 HSG C-(AD)₂-Fab-h679 HSGC-AD2-Fab-h734 Indium-DTPA C-AD2-Fab-hA20 CD20 C-AD2-Fab-hA20L CD20C-AD2-Fab-hL243 HLA-DR C-AD2-Fab-hLL2 CD22 N-AD2-Fab-hLL2 CD22C-AD2-IgG-hMN-14 CEACAM5 C-AD2-IgG-hR1 IGF-1R C-AD2-IgG-hRS7 EGP-1C-AD2-IgG-hPAM4 MUC C-AD2-IgG-hLL1 CD74 C-DDD1-Fab-hMN-14 CEACAM5C-DDD2-Fab-hMN-14 CEACAM5 C-DDD2-Fab-h679 HSG C-DDD2-Fab-hA19 CD19C-DDD2-Fab-hA20 CD20 C-DDD2-Fab-hAFP AFP C-DDD2-Fab-hL243 HLA-DRC-DDD2-Fab-hLL1 CD74 C-DDD2-Fab-hLL2 CD22 C-DDD2-Fab-hMN-3 CEACAM6C-DDD2-Fab-hMN-15 CEACAM6 C-DDD2-Fab-hPAM4 MUC C-DDD2-Fab-hR1 IGF-1RC-DDD2-Fab-hRS7 EGP-1 N-DDD2-Fab-hMN-14 CEACAM5

PKA RIβ (SEQ ID NO: 43)SLKGCELYVQLHGIQQVLKDCIVHLCISKPERPMKFLREHFEKLEKEENR QILA PKA RIIα(SEQ ID NO: 44) SHIQIPPGLTELLQGYTVEVGQQPPDLVDFAVEYFTRLREARRQ PKA RIIβ(SEQ ID NO: 45) SIEIPAGLTELLQGFTVEVLRHQPADLLEFALQHFTRLQQENER

The structure-function relationships of the AD and DDD domains have beenthe subject of investigation. (See, e.g., Burns-Hamuro et al., 2005,Protein Sci 14:2982-92; Carr et al., 2001, J Biol Chem 276:17332-38;Alto et al., 2003, Proc Natl Acad Sci USA 100:4445-50; Hundsrucker etal., 2006, Biochem J 396:297-306; Stokka et al., 2006, Biochem J400:493-99; Gold et al., 2006, Mol Cell 24:383-95; Kinderman et al.,2006, Mol Cell 24:397-408, the entire text of each of which isincorporated herein by reference.)

For example, Kinderman et al. (2006) examined the crystal structure ofthe AD-DDD binding interaction and concluded that the human DDD sequencecontained a number of conserved amino acid residues that were importantin either dimer formation or AKAP binding, underlined in SEQ ID NO:33below. (See FIG. 1 of Kinderman et al., 2006, incorporated herein byreference.) The skilled artisan will realize that in designing sequencevariants of the DDD sequence, one would desirably avoid changing any ofthe underlined residues, while conservative amino acid substitutionsmight be made for residues that are less critical for dimerization andAKAP binding.

(SEQ ID NO: 33) SHIQIPPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA

Alto et al. (2003) performed a bioinformatic analysis of the AD sequenceof various AKAP proteins to design an RII selective AD sequence calledAKAP-IS (SEQ ID NO:35), with a binding constant for DDD of 0.4 nM. TheAKAP-IS sequence was designed as a peptide antagonist of AKAP binding toPKA. Residues in the AKAP-IS sequence where substitutions tended todecrease binding to DDD are underlined in SEQ ID NO:35. The skilledartisan will realize that in designing sequence variants of the ADsequence, one would desirably avoid changing any of the underlinedresidues, while conservative amino acid substitutions might be made forresidues that are less critical for DDD binding.

AKAP-IS SEQUENCE QIEYLAKQIVDNAIQQA (SEQ ID NO: 35)

Gold (2006) utilized crystallography and peptide screening to develop aSuperAKAP-IS sequence (SEQ ID NO:46), exhibiting a five order ofmagnitude higher selectivity for the RH isoform of PKA compared with theRI isoform. Underlined residues indicate the positions of amino acidsubstitutions, relative to the AKAP-IS sequence, which increased bindingto the DDD moiety of RIIα. In this sequence, the N-terminal Q residue isnumbered as residue number 4 and the C-terminal A residue is residuenumber 20. Residues where substitutions could be made to affect theaffinity for RIIα were residues 8, 11, 15, 16, 18, 19 and 20 (Gold etal., 2006). It is contemplated that in certain alternative embodiments,the SuperAKAP-IS sequence may be substituted for the AKAP-IS AD moietysequence to prepare DNL constructs. Other alternative sequences thatmight be substituted for the AKAP-IS AD sequence are shown in SEQ IDNO:47-49. Substitutions relative to the AKAP-IS sequence are underlined.It is anticipated that, as with the AD2 sequence shown in SEQ ID NO:46,the AD moiety may also include the additional N-terminal residuescysteine and glycine and C-terminal residues glycine and cysteine.

SuperAKAP-IS QIEYVAKQIVDYAIHQA (SEQ ID NO: 46)Alternative AKAP sequences QIEYKAKQIVDHAIHQA (SEQ ID NO: 47)QIEYHAKQIVDHAIHQA (SEQ ID NO: 48) QIEYVAKQIVDHAIHQA (SEQ ID NO: 49)

FIG. 2 of Gold et al. disclosed additional DDD-binding sequences from avariety of AKAP proteins, shown below.

RII-Specific AKAPs AKAP-KL PLEYQAGLLVQNAIQQAI (SEQ ID NO: 50) AKAP79LLIETASSLVKNAIQLSI (SEQ ID NO: 51) AKAP-Lbc LIEEAASRIVDAVIEQVK(SEQ ID NO: 52) RI-Specific AKAPs AKAPce ALYQFADRFSELVISEAL(SEQ ID NO: 53) RIAD LEQVANQLADQIIKEAT (SEQ ID NO: 54) PV38FEELAWKIAKMIWSDVF (SEQ ID NO: 55) Dual-Specificity AKAPs AKAP7ELVRLSKRLVENAVLKAV (SEQ ID NO: 56) MAP2D TAEEVSARIVQVVTAEAV(SEQ ID NO: 57) DAKAP1 QIKQAAFQLISQVILEAT (SEQ ID NO: 58) DAKAP2LAWKIAKMIVSDVMQQ (SEQ ID NO: 59)

Stokka et al. (2006) also developed peptide competitors of AKAP bindingto PKA, shown in SEQ ID NO:60-62. The peptide antagonists weredesignated as Ht31 (SEQ ID NO:60), RIAD (SEQ ID NO:61) and PV-38 (SEQ IDNO:62). The Ht-31 peptide exhibited a greater affinity for the RHisoform of PKA, while the RIAD and PV-38 showed higher affinity for RI.

Ht31 DLIEEAASRIVDAVIEQVKAAGAY (SEQ ID NO: 60) RIAD LEQYANQLADQIIKEATE(SEQ ID NO: 61) PV-38 FEELAWKIAKMIWSDVFQQC (SEQ ID NO: 62)

Hundsrucker et al. (2006) developed still other peptide competitors forAKAP binding to PKA, with a binding constant as low as 0.4 nM to the DDDof the RII form of PKA. The sequences of various AKAP antagonisticpeptides are provided in Table 1 of Hundsrucker et al., reproduced inTable 3 below. AKAPIS represents a synthetic RII subunit-bindingpeptide. All other peptides are derived from the RII-binding domains ofthe indicated AKAPs.

TABLE 3 AKAP Peptide sequences Peptide Sequence AKAPIS QIEYLAKQIVDNAIQQA(SEQ ID NO: 35) AKAPIS-P QIEYLAKQIPDNAIQQA (SEQ ID NO: 63) Ht31KGADLIEEAASRIVDAVIEQVKAAG (SEQ ID NO: 64) Ht31-PKGADLIEEAASRIPDAPIEQVKAAG (SEQ ID NO: 65) AKAP7δ-wt-pepPEDAELVRLSKRLVENAVLKAVQQY (SEQ ID NO: 66) AKAP7δ-L304T-pepPEDAELVRTSKRLVENAVLKAVQQY (SEQ ID NO: 67) AKAP7δ-L308D-pepPEDAELVRLSKRDVENAVLKAVQQY (SEQ ID NO: 68) AKAP7δ-P-pepPEDAELVRLSKRLPENAVLKAVQQY (SEQ ID NO: 69) AKAP7δ-PP-pepPEDAELVRLSKRLPENAPLKAVQQY (SEQ ID NO: 70) AKAP7δ-L314E-pepPEDAELVRLSKRLVENAVEKAVQQY (SEQ ID NO: 71) AKAP1-pepEEGLDRNEEIKRAAFQIISQVISEA (SEQ ID NO: 72) AKAP2-pepLVDDPLEYQAGLLVQNAIQQAIAEQ (SEQ ID NO: 73) AKAP5-pepQYETLLIETASSLVKNAIQLSIEQL (SEQ ID NO: 74) AKAP9-pepLEKQYQEQLEEEVAKVIVSMSIAFA (SEQ ID NO: 75) AKAP10-pepNTDEAQEELAWKIAKMIVSDIMQQA (SEQ ID NO: 76) AKAP11-pepVNLDKKAVLAEKIVAEAIEKAEREL (SEQ ID NO: 77) AKAP12-pepNGILELETKSSKLVQNIIQTAVDQF (SEQ ID NO: 78) AKAP14-pepTQDKNYEDELTQVALALVEDVINYA (SEQ ID NO: 79) Rab32-pepETSAKDNINIEEAARFLVEKILVNH (SEQ ID NO: 80)

Residues that were highly conserved among the AD domains of differentAKAP proteins are indicated below by underlining with reference to theAKAP IS sequence (SEQ ID NO:35). The residues are the same as observedby Alto et al. (2003), with the addition of the C-terminal alanineresidue. (See FIG. 4 of Hundsrucker et al. (2006), incorporated hereinby reference.) The sequences of peptide antagonists with particularlyhigh affinities for the RII DDD sequence were those of AKAP-IS,AKAP7δ-wt-pep, AKAP7δ-L304T-pep and AKAP7δ-L308D-pep.

AKAP-IS QIEYLAKQIVDNAIQQA (SEQ ID NO: 35)

Carr et al. (2001) examined the degree of sequence homology betweendifferent AKAP-binding DDD sequences from human and non-human proteinsand identified residues in the DDD sequences that appeared to be themost highly conserved among different DDD moieties. These are indicatedbelow by underlining with reference to the human PKA RIIα DDD sequenceof SEQ ID NO:33. Residues that were particularly conserved are furtherindicated by italics. The residues overlap with, but are not identicalto those suggested by Kinderman et al. (2006) to be important forbinding to AKAP proteins. The skilled artisan will realize that indesigning sequence variants of DDD, it would be most preferred to avoidchanging the most conserved residues (italicized), and it would bepreferred to also avoid changing the conserved residues (underlined),while conservative amino acid substitutions may be considered forresidues that are neither underlined nor italicized.

(SEQ ID NO: 33) SHIQ IP P GL TELLQGYT V EVLR Q QP P DLVEFA VE YF TR LREA R A

The skilled artisan will realize that these and other amino acidsubstitutions in the antibody moiety or linker portions of the DNLconstructs may be utilized to enhance the therapeutic and/orpharmacokinetic properties of the resulting DNL constructs.

Example 7 Antibody-Dendrimer DNL Complex

We synthesized and characterized a novel immunoconjugate, designatedE1-G5/2, which was made by the DNL method to comprise half of ageneration 5 (G5) PAMAM dendrimer (G5/2) site-specifically linked to astabilized dimer of Fab derived from hRS7, a humanized antibody that israpidly internalized upon binding to the Trop-2 antigen expressed onvarious solid cancers.

Methods

E1-G5/2 was prepared by combining two self-assembling modules, AD2-G5/2and hRS7-Fab-DDD2, under mild redox conditions, followed by purificationon a Protein L column. To make AD2-G5/2, we derivatized the AD2 peptidewith a maleimide group to react with the single thiol generated fromreducing a G5 PAMAM with a cystamine core and used reversed-phase HPLCto isolate AD2-G5/2. We produced hRS7-Fab-DDD2 as a fusion protein inmyeloma cells, as described in the Examples above.

The molecular size, purity and composition of E1-G5/2 were analyzed bysize-exclusion HPLC, SDS-PAGE, and Western blotting. The biologicalfunctions of E1-G5/2 were assessed by binding to an anti-idiotypeantibody against hRS7, a gel retardation assay, and a DNase protectionassay.

Results

E1-G5/2 was shown by size-exclusion HPLC to consist of a major peak(>90%) flanked by several minor peaks. The three constituents of E1-G5/2(Fd-DDD2, the light chain, and AD2-G5/2) were detected by reducingSDS-PAGE and confirmed by Western blotting. Anti-idiotype bindinganalysis revealed E1-G5/2 contained a population of antibody-dendrimerconjugates of different size, all of which were capable of recognizingthe anti-idiotype antibody, thus suggesting structural variability inthe size of the purchased G5 dendrimer.

CONCLUSION

The DNL technique can be used to build dendrimer-based nanoparticlesthat are targetable with antibodies. Such agents have improvedproperties as carriers of drugs, plasmids or siRNAs for applications invitro and in vivo.

Example 8 Maleimide AD2 Conjugate for DNL Dendrimers

The peptide IMP 498 up to and including the PEG moiety was synthesizedon a Protein Technologies PS3 peptide synthesizer by the Fmoc method onSieber Amide resin (0.1 mmol scale). The maleimide was added manually bymixing the β-maleimidopropionic acid NHS ester withdiisopropylethylamine and DMF with the resin for 4 hr. The peptide wascleaved from the resin with 15 mL TFA, 0.5 mL H₂O, 0.5 mLtriisopropylsilane, and 0.5 mL thioanisole for 3 hr at room temperature.The peptide was purified by reverse phase HPLC using H₂O/CH₃CN TFAbuffers to obtain about 90 mg of purified product after lyophilization.

Synthesis of Reduced G5 Dendrimer (G512)

The G-5 dendrimer (10% in MeOH, Dendritic Nanotechnologies), 2.03 g,7.03×10⁻⁶ mol was reduced with 0.1426 TCEP.HCl 1:1 MeOH/H₂O (˜4 mL) andstirred overnight at room temperature. The reaction mixture was purifiedby reverse phase HPLC on a C-18 column eluted with 0.1% TFA H₂O/CH₃CNbuffers to obtain 0.0633 g of the desired product after lyophilization.

Synthesis of G5/2 Dendrimer-AD2 Conjugate

The G5/2 Dendrimer, 0.0469 g (3.35×10⁻⁶ mol) was mixed with 0.0124 g ofIMP 498 (4.4×10⁻⁶ mol) and dissolved in 1:1 MeOH/1M NaHCO₃ and mixed for19 hr at room temperature followed by treatment with 0.0751 gdithiothreitol and 0.0441 g TCEP.HCl. The solution was mixed overnightat room temperature and purified on a C4 reverse phase HPLC column using0.1% TFA H₂O/CH₃CN buffers to obtain 0.0033 g of material containing theconjugated AD2 and dendrimer as judged by gel electrophoresis andWestern blot.

Example 9 Delivery System for Cytotoxic Drugs Via Bispecific AntibodyPretargeting

As discussed above, pretargeting methods have been used with bispecificantibodies and targetable constructs for improved targeted delivery oftherapeutic agents with decreased systemic toxicity. In pretargeting,the bispecific antibody (bsMAb) is administered first to the subject andallowed to localize to a targeted cell or tissue. Optionally, a clearingagent may be administered to expedite clearance of the bsMAb fromcirculation. After the bsMAb has cleared from circulation, a targetableconstruct is administered that binds to the bsMAb localized in thetarget tissue. The targetable construct is conjugated to one or moretherapeutic and/or diagnostic agents. Because the targetable constructclears very rapidly from circulation and is typically excreted intact,primarily in the urine, the cytotoxic therapeutic agent spends littletime in circulation and is not taken up by non-targeted tissues, thusreducing systemic toxicity.

The object of the present Example was to develop novel reagents for usein therapeutic pretargeting. These were tested in an animal model forhuman colorectal cancer, using an anti-carcinoembryonic antigen(CEACAM5) bispecific antibody. An exemplary cytotoxic drug used in thepretargeting study was SN-38.

A core peptide targetable construct, described in detail below (IMP457), was developed. The targetable construct was modified to attachSN-38 and can attach up to 4 SN-38 moieties per core peptide. A dendronpolymer was also prepared that can bind 8 to 16 SN-38 moieties perpolymer molecule. The targetable construct has the ability to bind boththerapeutic radionuclides and chemotherapeutic agents for combinationtherapy of diseased tissues, such as cancer.

An exemplary bispecific antibody used was the TF2 DNL construct,described in the Examples above. TF2 contains two CEACAM5-binding hMN-14Fab moieties and one HSG-binding h679 Fab moiety. The targetableconstruct contained two HSG haptens per peptide to allow cross-linkingof two TF2 bsMAbs at the tumor surface. Cross-linking of the twobispecific antibodies enhances the retention of pretargeted peptide onthe tumor surface (Barbet et al., 1999, Cancer Biother Radiopharm14:153-66).

Preferably, the peptide-drug conjugates are designed to allow for theslow release of the drug, for example with a drug linkage that is stablefor up to 1 day, but then released in a time-dependent manner. Thismatches the kinetics of pretargeting, where the peptide reaches maximumaccumulation in the tumor within 1 h, and over the next few hours over90% is cleared from the bloodstream by urinary excretion. Unlike directdrug-antibody conjugates that are retained in the body for sustainedperiods, allowing catabolism in the liver and other organs, inpretargeting most of the injected product is excreted intact to minimizesystemic side effects. But the drug-peptide conjugate localized in thetumor is slowly released within the tumor.

Synthesis of Targetable Construct Peptides

Peptides were synthesized by solid phase peptide synthesis using acombination of Aloc and Fmoc protecting groups to allow selectivemodification of peptide side chains and elongation of the peptide duringpeptide synthesis. IMP 402 was initially synthesized and used to makeIMP 453, according to FIG. 1. IMP 402 is also suitable for conjugationto a dendron drug carrier.

IMP 402 was synthesized on Sieber amide resin as follows.Aloc-D-Lys(Fmoc)-OH was attached to the resin. The lysine side chainFmoc was removed and the N-Trityl-histaminyl-succinyl-glycyl group(Trityl-HSG-OH) was attached. The Aloc group was removed from the lysineand the Fmoc-D-Tyr(But)-OH was added to the peptide. AnotherAloc-D-Lys(Fmoc)-OH was added to the peptide and the Trityl-HSG-OH groupwas added to that lysine side chain. The Aloc group was removed from thelysine and Fmoc-D-Ala-OH, Fmoc-D-Cys(Trt)-OH and Tri-t-butyl-DOTA-OHwere added to the peptide using standard peptide coupling methods. Thepeptide was cleaved from the resin and purified by HPLC.

Synthesis of Peptide Drug Conjugates

The synthesis of the SN-38 precursor needed for peptide coupling isshown in FIG. 2. The 10 position of SN-38 was first protected with a Bocgroup and the 20 position was then modified with p-nitrophenylchloroformate to produce the 10-Boc-20-p-nitrophenylcarbonate SN-38precursor. The activated SN-38 was then mixed with the peptide toproduce the Boc-SN-38 protected conjugate, which was purified by HPLC.The Boc group was then removed under mild conditions to produce thedesired product in 20% overall yield for the whole conjugation process.The resulting SN-38-conjugated peptide IMP 453 contains one DOTA, oneSN-38 and two HSG moieties.

An initial study with ¹¹¹In-labeled IMP 453 showed excellent tumortargeting to the LS174 human colon cancer cell line (28% ID/g) (Table4). Most of the peptide was cleared by urinary excretion (Table 4).Renal uptake at 3 hr was elevated (21% ID/g), higher than was observedwith bis-DTPA peptides (not shown), but 50% of the initial kidney uptakewas eliminated by 24 hr. When the peptide was injected in mice that didnot receive bispecific antibody, kidney uptake was only 9.97% ID/g(Table 5). The higher uptake in the kidneys of pretargeted mice isprobably due the presence of bispecific antibody in the blood or kidney.Modification of the peptide to contain a DTPA instead of DOTA chelatingmoiety may reduce kidney uptake, to the same range as seen with bis-DTPApeptides like IMP 225 and IMP 274. In the absence of TF2, there waslittle uptake of labeled peptide into the tumor (Table 5).

TABLE 4 ¹¹¹In IMP 453 biodistribution in scLS174T tumor-bearing nudemice pretargeted with TF2. Tissue uptake shown as % ID/g. Tissue 3 Hr 24Hr 48 Hr Tumor 28.32 ± 4.03  15.44 ± 1.18  9.69 ± 1.97 Liver 0.56 ± 0.080.53 ± 0.19 0.36 ± 0.06 Spleen 0.37 ± 0.11 0.66 ± 0.89 0.25 ± 0.07Kidney 21.10 ± 4.14  10.00 ± 2.45  7.11 ± 1.17 Lung 0.56 ± 0.10 0.18 ±0.07 0.14 ± 0.03 Blood 0.29 ± 0.03 0.09 ± 0.04 0.04 ± 0.01 Stomach 0.41± 0.33 0.20 ± 0.12 0.07 ± 0.01 Sm. Int. 0.68 ± 0.45 0.22 ± 0.09 0.12 ±0.03 Lg. Int. 1.23 ± 1.41 0.23 ± 0.05 0.16 ± 0.07

TABLE 5 ¹¹¹In IMP 453 biodistribution in scLS174T tumor-bearing nudemice without bsMAb. Tissue 3 Hr Tumor 0.37 ± 0.09 Liver 0.37 ± 0.18Spleen 0.22 ± 0.07 Kidney 9.97 ± 0.94 Lung 0.31 ± 0.14 Blood 0.24 ± 0.01Stomach 0.11 ± 0.06 Sm. Int. 0.20 ± 0.10 Lg. Int. 0.52 ± 0.27

DTPA Conjugated Peptide

An analog of IMP 453 is synthesized as described above, with the DOTAgroup replaced by a DTPA group. The peptide is labeled with ¹¹¹In andthe tumor targeting and clearance of the peptide is examined in LS174Ttumor-bearing nude mice. The peptide shows targeting in vivo that issimilar to the DOTA labeled peptide, but with lower renal uptake at 3hours. The peptide toxicity is formulated in an acetate buffer betweenpH 5-6 with an excipient added and lyophilized for therapeutic use.

Dendron Conjugation

The advantage of a dendron carrier molecule is that it is asymmetrical,with surface groups and a focal functional group for differentialsubstitutions. Attachment of the bis-HSG peptide at the defined focalsite results in site-specific placement. A PAMAM dendron is exemplifiedin FIG. 3, although other dendrons may be used with up to sixteensurface groups. Briefly, this involves multiple derivatizations withacetylene groups for introducing multiple molecules of SN-38 viaazide-yne click cycloaddition, as discussed above.

The focal functional group is transformed by ‘BOC’ deprotection andderivatization to a maleimide, which is conjugated to acysteine-containing-bis-HSG peptide for pretargeting. The same peptidealso contains a DOTA molecule that will enable labeling with In-111radiolabel for determining in vivo targeting. Dendron with either aminogroup or some other group on the surface is purchased if found to becost effective. Alternatively, the dendron specified is made in-house byan iterative sequence of methacrylate reaction and ethylenediamine-based esterolysis, starting with mono-protected1,6-diaminohexane. The BOC-protected amino group serves as the focalfunctional group that will ultimately carry the bis-HSG peptidesite-selectively.

Azido-SN-38 Preparation

For click chemistry reactions, such as the click chemistry addition ofSN-38 to a targetable construct, an azido-SN-38 moiety may be preparedto react with a cyclooctyne or alkyne moiety on the targetableconstruct. An exemplary preparation is shown in FIG. 4. SN-38 silylether (intermediate 1) has been prepared in a number of small scalereactions as well as in one large scale reaction, using 3.43 g SN-38with reproducibly >74% yield. The carbonate (intermediate 3) wasprepared five times, using cross-linker as a limiting reagent inquantities in the range of 0.24-2.0 g, to obtain the purified carbonatein 0.33-2.63 g (77-90%). At this stage, deblocking of silyl group waseffected and the material was purified by a simple aqueous work-up thatensured the removal of the fluoride reagent. The azido-SN-38, which isintermediate 4 in FIG. 4, is used for click cycloaddition to acetylenegroups on the dendrimer.

The click cycloaddition has been simplified from that published (Moon etal., 2008, Chemotherapy. Med. Chem. 51: 6916-6926) by resorting to ahomogeneous reaction in dichloromethane using triphenylphosphine andcuprous bromide in 0.1 to 0.2 equivalents, with attendant improvementsin the quality and the yield of the product. With the old method, theyield was 58-82%, while with the new method, it was 86%. We believe thisnew process is amenable to easy scale-up in view of the homogeneousreaction condition. The final reaction in the synthetic sequence is theremoval of ‘MMT’ group using a mild acid, such as dichloroacetic acid,which proceeds in a high yield. The click cycloaddition will also beexamined in aqueous reaction condition involving copper sulfate andascorbate, using DMSO as cosolvent.

From the foregoing description, one skilled in the art can easilyascertain the essential characteristics of this invention, and withoutdeparting from the spirit and scope thereof, can make various changesand modifications of the invention to adapt it to various usage andconditions without undue experimentation. All patents, patentapplications and publications cited herein are incorporated byreference.

1-19. (canceled)
 20. A method of delivering a therapeutic agent to asubject with a disease comprising: a) administering to the subject acomplex comprising, (i) an antibody or antigen-binding fragment thereofthat binds to an antigen on a diseased cell, tissue or organ; (ii) adendron attached to the antibody or antigen-binding fragment thereof;and (iii) two or more copies of a therapeutic agent attached to thedendron.
 21. The method of claim 20, wherein the antigen is atumor-associated antigen (TAA).
 22. The method of claim 21, wherein theTAA is selected from the group consisting of carbonic anhydrase IX,CCCL19, CCCL21, CSAp, CD1, CD1a, CD2, CD3, CD4, CD5, CD8, CD11A, CD14,CD15, CD16, CD18, CD19, IGF-1R, CD20, CD21, CD22, CD23, CD25, CD29,CD30, CD32b, CD33, CD37, CD38, CD40, CD40L, CD45, CD46, CD52, CD54,CD55, CD59, CD64, CD66a-e, CD67, CD70, CD74, CD79a, CD80, CD83, CD95,CD126, CD133, CD138, CD147, CD154, CXCR4, CXCR7, CXCL12, HIF-1α, AFP,PSMA, CEACAM5, CEACAM6, B7, ED-B of fibronectin, Factor H, FHL-1, Flt-3,folate receptor, GRO-β, HMGB-1, hypoxia inducible factor (HIF), HM1.24,insulin-like growth factor-1 (ILGF-1), IFN-γ, IFN-α, IFN-β, IL-2, IL-4R,IL-6R, IL-13R, IL-15R, IL-17R, IL-18R, IL-6, IL-8, IL-12, IL-15, IL-17,IL-18, IL-25, IP-10, MAGE, mCRP, MCP-1, MIP-1A, MIP-1B, MIF, MUC1, MUC2,MUC3, MUC4, MUC5, NCA-95, NCA-90, Ia, HM1.24, EGP-1, EGP-2, HLA-DR,tenascin, Le(y), RANTES, T101, TAC, Tn antigen, Thomson-Friedenreichantigens, tumor necrosis antigens, TNF-α, TRAIL receptor (R1 and R2),VEGFR, EGFR, PIGF, complement factors C3, C3a, C3b, C5a, C5, and anoncogene product.
 23. The method of claim 22, wherein the antibody isselected from the group consisting of hR1, hPAM4, hA20, hA19, hIMMU31,hLL1, hLL2, hMu-9, hL243, hMN-14, hMN-15, hRS7, hMN-3, Ab124 and Ab125.24. The method of claim 20, wherein the therapeutic agent is selectedfrom the group consisting of a toxin, drug, radionuclide,immunomodulator, cytokine, lymphokine, chemokine, growth factor, tumornecrosis factor, hormone, hormone antagonist, enzyme, oligonucleotide,siRNA, RNAi, photoactive therapeutic agent, anti-angiogenic agent andpro-apoptotic agent.
 25. The method of claim 24, wherein the drug isselected from the group consisting of a nitrogen mustard, ethyleniminederivative, alkyl sulfonate, nitrosourea, triazene, folic acid analog,anthracycline, taxane, COX-2 inhibitor, pyrimidine analog, purineanalog, antibiotic, enzyme inhibitor, epipodophyllotoxin, platinumcoordination complex, vinca alkaloid, substituted urea, methyl hydrazinederivative, adrenocortical suppressant, hormone antagonist, endostatin,camptothecin, antimetabolite, alkylating agent, antimitotic agent,anti-angiogenic agent, tyrosine kinase inhibitor, mTOR inhibitor, heatshock protein (HSP90) inhibitor, proteosome inhibitor, HDAC inhibitor,and pro-apoptotic agent.
 26. The method of claim 24, wherein the drug isselected from the group consisting of 5-fluorouracil, aplidin,azaribine, anastrozole, bendamustine, bleomycin, bortezomib,bryostatin-1, busulfan, calicheamycin, carboplatin,10-hydroxycamptothecin, carmustine, celecoxib, chlorambucil,cisplatinum, irinotecan (CPT-11), SN-38, carboplatin, cladribine,cyclophosphamide, cytarabine, dacarbazine, docetaxel, dactinomycin,daunorubicin, doxorubicin, 2-pyrrolinodoxorubicine (2P-DOX), pro-2P-DOX,cyano-morpholino doxorubicin, doxorubicin glucuronide, epirubicinglucuronide, estramustine, epipodophyllotoxin, estrogen receptor bindingagent, etoposide (VP16), etoposide glucuronide, etoposide phosphate,floxuridine (FUdR), 3′,5′-O-dioleoyl-FudR (FUdR-dO), fludarabine,flutamide, farnesyl-protein transferase inhibitors, gemcitabine,hydroxyurea, idarubicin, ifosfamide, L-asparaginase, lenolidamide,leucovorin, lomustine, mechlorethamine, melphalan, mercaptopurine,6-mercaptopurine, methotrexate, mitoxantrone, mithramycin, mitomycin,mitotane, navelbine, nitrosourea, plicomycin, procarbazine, paclitaxel,pentostatin, PSI-341, raloxifene, semustine, streptozocin, tamoxifen,temazolomide, transplatinum, thalidomide, thioguanine, thiotepa,teniposide, topotecan, uracil mustard, vinorelbine, vinblastine, andvincristine.
 27. The method of claim 24, wherein the toxin is selectedfrom the group consisting of ricin, abrin, alpha toxin, saporin,ribonuclease (RNase), DNase I, Staphylococcal enterotoxin-A, pokeweedantiviral protein, gelonin, diphtheria toxin, Pseudomonas exotoxin, andPseudomonas endotoxin.
 28. The method of claim 24, wherein theradionuclide is selected from the group consisting of ^(103m)Rh, ¹⁰³Ru,¹⁰⁵Rh, ¹⁰⁵Ru, ¹⁰⁷Hg, ¹⁰⁹Pd, ¹⁰⁹Pt, ¹¹¹Ag, ¹¹¹In, ^(113m)In, ¹⁹Sb, ¹¹C,^(121m)Te, ^(122m)Te, ¹²⁵I, ¹²⁵Te, ¹²⁶I, ¹³¹I, ¹³³I, ¹³N, ¹⁴²Pr, ¹⁴³Pr,¹⁴⁹Pm, ¹⁵²Dy, ¹⁵³Sm, ¹⁵O, ¹⁶¹Ho, ¹⁶¹Tb, ¹⁶⁵Tm, ¹⁶⁶Dy, ¹⁶⁶Ho, ¹⁶⁷Tm,¹⁶⁸Tm, ¹⁶⁹Er, ¹⁶⁹Yb, ¹⁷⁷Lu, ¹⁸⁶Re, ¹⁸⁸Re, ^(189m)Os, ¹⁸⁹Re, ¹⁹²Ir,¹⁹⁴Ir, ¹⁹⁷Pt, ¹⁹⁸Au, ¹⁹⁹Au, ²⁰¹Tl, ²⁰³Hg, ²¹¹At, ²¹¹Bi, ²¹¹Pb, ²¹²Bi,²¹²Pb, ²¹³Bi, ²¹⁵Po, ²¹⁷At, ²¹⁹Rn, ²²¹Fr, ²²³Ra, ²²⁴Ac, ²²⁵Ac, ²²⁵Fm,³²P, ³³P, ⁴⁷Sc, ⁵¹Cr, ⁵⁷Co, ⁵⁸Co, ⁵⁹Fe, ⁶²Cu, ⁶⁷Cu, ⁶⁷Ga, ⁷⁵Br, ⁷⁵Se,⁷⁶Br, ⁷⁷As, ⁷⁷Br, ^(80m)Br, ⁸⁹Sr, ⁹⁰Y, ⁹⁵Ru, ⁹⁷Ru, ⁹⁹Mo and ^(99m)Tc.29. The method of claim 24, wherein the radionuclide is analpha-particle-emitting radionuclide.
 30. The method of claim 24,wherein the enzyme is selected from the group consisting of malatedehydrogenase, staphylococcal nuclease, delta-V-steroid isomerase, yeastalcohol dehydrogenase, alpha-glycerophosphate dehydrogenase, triosephosphate isomerase, horseradish peroxidase, alkaline phosphatase,asparaginase, glucose oxidase, beta-galactosidase, ribonuclease, urease,catalase, glucose-6-phosphate dehydrogenase, glucoamylase andacetylcholinesterase.
 31. The method of claim 20, wherein the subject isa human subject.
 32. The method of claim 31, wherein the subject has adisease selected from the group consisting of cancer, autoimmunedisease, immune system dysfunction, infectious disease, cardiovasculardisease, metabolic disease and neurodegenerative disease.
 33. The methodof claim 20, wherein the therapeutic agent is SN-38.
 34. The method ofclaim 20, wherein four copies of the therapeutic agent are attached tothe dendron.
 35. The method of claim 20, wherein 8 to 16 copies of thetherapeutic agent are attached to the dendron.